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Antiphospholipid and thrombosis syndromes

R L Bick1, W F Baker

  • 1Presbyterian Comprehensive Cancer Center, Presbyterian Hospital of Dallas, TX 75231.

Seminars in Thrombosis and Hemostasis
|January 1, 1994
PubMed
Summary

Anticardiolipin antibodies (ACAs) and lupus anticoagulant are key acquired blood defects linked to thrombosis. Prompt testing for these and defining syndrome types are crucial for managing unexplained thrombotic events.

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Area of Science:

  • Hematology
  • Immunology
  • Vascular Medicine

Background:

  • Antiphospholipid antibodies (ACAs) and lupus anticoagulant are common acquired defects associated with thrombosis.
  • The exact mechanisms by which these antibodies induce a hypercoagulable state are still under investigation.

Purpose of the Study:

  • To highlight the association between ACAs and thrombosis.
  • To emphasize the importance of identifying ACA types and associated syndromes for effective anticoagulant therapy.

Main Methods:

  • Review of clinical associations between antiphospholipid antibodies and thrombotic events.
  • Discussion of diagnostic approaches including ELISA for ACA and dRVVT for lupus anticoagulant.
  • Classification of thrombotic events into syndrome types (I-IV).

Main Results:

  • ACAs are strongly linked to venous (DVT, PE), arterial (coronary, peripheral), and cerebrovascular thrombosis.
  • Different syndrome types (I-IV) associated with ACAs may influence treatment strategies.
  • Primary lupus anticoagulant thrombosis syndrome typically involves venous thrombosis.

Conclusions:

  • ACAs and lupus anticoagulant should be investigated in patients with unexplained thrombosis.
  • Assessing all three ACA idiotypes (IgG, IgA, IgM) is recommended.
  • Definitive diagnostic tests are essential due to the unreliability of aPTT in these conditions.

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