Cerebral ischemia in the presence of lupus anticoagulant

Two patients with manifestations of cerebral ischemia were found to have a circulating coagulation inhibitor. This immunoglobulin, termed lupus anticoagulant, results in a prolonged partial thromboplastin time. Paradoxically, it is usually associated with a thrombotic tendency rather than a bleeding diathesis. It is most commonly found in systemic lupus erythematosus, which our patients did not have. These two patients represent the interesting phenomenon of cerebral ischemia in the presence of an endogenous inhibitor of coagulation.