Autoimmune Diseases Affecting Hemostasis: A Narrative Review.

Area of Science:

• Hematology
• Immunology
• Internal Medicine

Background:

• Hemostasis is a critical balance between pro-coagulant and anti-coagulant forces.
• Imbalances can result in bleeding disorders or thrombosis.
• Autoimmune diseases significantly impact hemostasis, causing diverse clinical outcomes.

Purpose of the Study:

• To review the intricate relationship between autoimmune diseases and hemostasis.
• To highlight how autoimmunity can lead to both bleeding and thrombotic events.
• To discuss contemporary examples like COVID-19 in the context of autoimmune-mediated hemostatic dysregulation.

Main Methods:

• This study is a narrative review.
• It synthesizes existing literature on autoimmunity and hemostasis.
• Key examples of autoimmune conditions affecting blood clotting are discussed.

Main Results:

• Autoantibodies against clotting factors can cause bleeding, exemplified by acquired hemophilia A.
• Antibodies targeting phospholipids promote thrombosis, as seen in antiphospholipid syndrome (APS).
• Emerging conditions like COVID-19 demonstrate autoimmunity's potential to induce thrombotic tendencies, with occasional bleeding risks.

Conclusions:

• Autoimmune processes represent a significant, often underappreciated, cause of hemostatic abnormalities.
• Understanding these interactions is crucial for diagnosing and managing patients with both autoimmune diseases and bleeding/thrombotic disorders.
• Further research into the mechanisms linking autoimmunity and hemostasis is warranted.