Circulating anticoagulant in CREST syndrome

We report the discovery of a circulating anticoagulant in a patient suffering from CREST syndrome. The patient was first seen with a microangiopathic haemolytic anaemia which led to the diagnosis of the CREST syndrome. Several months later, prior to a cataract operation, a routine coagulation screen (prothrombin time and partial thromboplastin time) was abnormal. Investigation showed the presence of a circulating anticoagulant as well as a decrease in several clotting factors, principally factor VIII C.