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Medicine General ca76df4b

All of the following statements about Lupus Anticoagulant are true, Except.

A
May present with an isolated prolongation of APTT
B
May present with Recurrent Aboions
C
May occur with minimal clinical manifestations
D
Thrombotic spells can be followed by severe life threatening haemmorrhage
High-Yield Explanation
Answer is D (Thrombotic spells can be followed by severe life threatening haemmorrhage): Bleeding episodes after Thrombotic spells may occur as a result of consumptive Thrombocytopenia. However such bleeding episodes are rare even with severe thrombocytopenia and do not lead to life threatening haemorrhage. Catastrophic Life threatening Antiphospholipid Syndrome results from rapid onset thrombosis and ischemia in multiple organ systems and not from severe bleeding. Bleeding is rarely associated with Lupus Anticoagulant Lupus Anticoagulant may cause thrombocytopenia, but bleeding complications secondary to thrombocytopenia are rare & severe life threatening bleeding due to Lupus anticoagulant has not been repoed in any standard text book. `Although Thrombocytopenia is a common finding in patients with APS, bleeding complications are rare, even with severe thrombocytopenia Bleeding in an APS patient should trigger evaluation for the presence of antiprothrombin antibodies and other disorders that may affect hemostasis, such as DIC & Uremia' - William's Hematology `Bleeding is unsual in APS despite the prolongation of in vitro clotting time. When bleeding is present it suggests the presence of antiprothrombin antibody with hypoprothrombinemia but it may rarely be caused by thrombocytopenia'. - Samter's Immunologic diseases

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