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Lupus anticoagulants, anticardiolipin antibodies, and cerebral ischemia

M Kushner1, N Simonian

  • 1Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia 19104.

Stroke
|February 1, 1989
PubMed

Insights

This study found that patients with cerebral ischemia and antiphospholipid antibodies, such as lupus anticoagulant (LA) and anticardiolipin antibodies (ACA), often experience recurrent strokes. Laboratory test results for LA and ACA can be inconsistent, highlighting diagnostic challenges.

Area of Science:

  • Neurology
  • Rheumatology
  • Immunology

Background:

  • Cerebral ischemia is a significant cause of neurological disability.
  • Antiphospholipid antibodies, including lupus anticoagulant (LA) and anticardiolipin antibodies (ACA), are associated with an increased risk of thrombosis.
  • The role of these antibodies in patients with cerebral ischemia requires further elucidation.

Purpose of the Study:

  • To investigate the prevalence and clinical characteristics of cerebral ischemia in patients with laboratory evidence of lupus anticoagulant (LA) or anticardiolipin antibodies (ACA).
  • To assess the association between these antibodies and cerebrovascular events.
  • To evaluate the heterogeneity of laboratory findings in this patient cohort.

Main Methods:

  • Retrospective analysis of 23 patients with cerebral ischemia and positive laboratory tests for LA or ACA.
  • Clinical data collection including medical history, neurological examination, and presence of collagen-vascular disease.
  • Laboratory testing for LA and ACA, including assessment of partial thromboplastin time.

Main Results:

  • 71% of patients experienced multiple cerebral ischemic events; two had multi-infarct dementia.
  • 57% of patients had recognized cerebrovascular disease risk factors.
  • LA was identified in 15/21 patients, and elevated ACA titer in 10/12 patients; assays were discordant in 8/10.
  • Only 35% of patients had a prolonged partial thromboplastin time.

Conclusions:

  • Cerebral ischemia associated with LA and ACA is often recurrent.
  • Other cerebrovascular disease risk factors are frequently present in these patients.
  • Significant heterogeneity exists in laboratory findings for LA and ACA, posing diagnostic challenges.

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