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Cerebrovascular ischemia associated with lupus anticoagulant.

Abstract
The lupus anticoagulant, an acquired circulating serum gamma-globulin, prolongs all phospholipid-dependent coagulation tests. Recent associations of the lupus anticoagulant and focal cerebral and/or ocular ischemia have been made. We present 5 cases of lupus anticoagulant-associated cerebrovascular ischemia and review all reported cases for the first time. Clinical spectra, cerebral angiographic findings, associated conditions, and response to therapy are presented. Typical features include a relatively young age (mean 39 years), female preponderance, transient ischemic attacks (including amaurosis fugax) or stroke, and normal or large vessel occlusions on angiography. Commonly associated conditions were systemic lupus erythematosus (34%), noncerebral venous thrombosis (31%), hypertension (28%), false-positive VDRL (28%), and spontaneous abortions (22%). Four of our 5 patients (all without systemic lupus erythematosus) and 11 of the 20 (55%) patients in the literature without systemic lupus erythematosus had other definite stroke risk factors coexisting. Response to therapy was highly variable, with no clear beneficial effect of corticosteroids.
AuthorsS R Levine, K M Welch
JournalStroke (Stroke) 1987 Jan-Feb Vol. 18 Issue 1 Pg. 257-63 ISSN: 0039-2499 [Print] United States
PMID3101233 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Blood Coagulation Factors
  • Lupus Coagulation Inhibitor
Topics
  • Adult
  • Aged
  • Blood Coagulation Factors (antagonists & inhibitors, metabolism)
  • Brain Ischemia (complications, diagnostic imaging, drug therapy, metabolism)
  • Cerebral Angiography
  • Female
  • Humans
  • Lupus Coagulation Inhibitor
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed

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