Recurrent ischemic attacks in two young adults with lupus anticoagulant

Two young adults with lupus anticoagulant had multiple attacks of cerebrovascular ischemia in different arterial territories. Cerebral angiography was normal. One patient had a new episode during anticoagulant therapy, but has remained asymptomatic on antiplatelet treatment. In the other, further events occurred during treatment with platelet-inhibiting drugs, but there have been no recurrences with adequate anticoagulant therapy. Lupus anticoagulants are possible causes of otherwise unexplained thromboembolic events. Due to the variable mode of action of these immunoglobulins, platelet-inhibiting drugs may in some cases be considered as a prophylactic alternative to anticoagulant treatment.