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Medical Definition of Lupus anticoagulants
1. Lupus anticoagulants are a common cause of a prolonged activated partial thromboplastin time (APTT) which is corrected by the addition of platelet -rich plasma (or phospholipids) and not by platelet-poor plasma. The methods of choice for detection of lupus anticoagulants are the kaolin clotting time using the rabbit brain neutralisation procedure and the dilute Russell viper venom test (dRVVT). Current data suggest that lupus anticoagulants and antibodies to negatively charged phospholipids (cardiolipin, phosphatidylserine, phosphatidic acid and phosphatidylinositol) are risk factors for arterial and venous thrombosis and for recurrent abortions in populations of patients which are distinct but overlapping. Drug-induced lupus anticoagulants are also associated with increased risk of thrombosis. Current testing for lupus anticoagulants and phospholipid antibodies (cardiolipin plus phosphatidylserine) may be useful for assessing risk in patients with systemic lupus erythematosus. Some data indicate that lupus anticoagulants assays are more reliable predictors of thrombosis, foetal loss and thrombocytopenia than are cardiolipin antibody (ACA) assays. Although the technology is in many ways more reliable, the rush to describe associations of lupus anticoagulants with various disorders has been much less scientifically unseemly than has been that of ACAs with their bewildering variety of clinical associations. The contribution of one serious study must, it seems, render tolerable the excess of trivia recently published in this area. See also cardiolipin antibodies and phospholipid antibodies. (05 Mar 2000)