Lupus anticoagulant is a problem wherein the autoantibodies in an individual bind to proteins and phospholipids that are associated with cell membranes. This can affect blood clotting as interaction between clotting factors and cell membranes is essential for the correct activity of a coagulation cascade.
Lupus anticoagulant can basically be understood as a tendency of the antiphopholipid antibodies to delay the clotting time. Diagnosis of this problem is often done in patients that are asymptomatic by way of a routine blood testing before any surgery. Individuals with lupus anticoagulant can develop thrombosis along with excessive bleeding and may also experience habitual abortions.
Many patients who have the condition of lupus anticoagulant do not have lupus erythematosus and a very small number of these patients actually develop this disease. However those who have lupus erythematosus have a greater likelihood of developing lupus anticoagulant as compared to the general population.
A routine plasma test usually reflects delayed clotting time and this will be followed with functional testing to determine the function of blood clotting. Along with functional testing serological testing may be undertaken to determine common autoantibodies like antiphophslipid antibodies. Such antibodies delay the in-vitro coagulation in the laboratory tests dependent on phospholipid.
In the initial stages after the workup the patient’s plasma is taken and mixed with plasma that is pooled normally and after this the clotting is re-assessed. If lupus anticoagulant is present then it will act as an inhibiter and the result will be an abnormal clotting time. If the clotting time becomes normal then the presence of lupus coagulant is not considered.
The results of the mixing test are confirmed with a test like Kaolin clotting time or the dilute Russel’s viper venom time. Individuals who have a well documented presence of lupus anticoagulant along with thrombosis history are considered to be candidates for treatment with anticoagulants for an indefinite time period. Those who do not have a history of thrombosis but have lupus anticoagulant should be observed. Individuals with this problem may experience possible frequent miscarriages.
Testing for lupus anticoagulant is done when any patient undergoes a thrombotic episode that cannot be explained. Such a testing is also undertaken in case the patient experiences recurrent miscarriages and it may also be ordered as a follow up for any prolonged PTT test. Any person who has an autoimmune disease like systemic lupus erythematosus but has tested negative for lupus anticoagulant may be required to undergo specific test such as the PTT. This is done so as to find out whether development of the antibody has occurred since the last test.