Thrombosis in systemic lupus erythematosus: The role of antiphospholipid antibody

Abstract

In general, patients with SLE may have confounding hemostatic or vascular abnormalities that may influence the thrombotic tendency and treatment decisions. Such abnormalities include thrombocytopenia or platelet dysfunction, autoantibodies against phospholipid-binding proteins (antiphospholipid antibodies/lupus anticoagulants) that may act as coagulation inhibitors, abnormalities in renal, hepatic, or thyroid function, or the nephrotic syndrome. Antiphospholipid antibodies have a major role in the pathogenesis of thrombosis in SLE patients; nearly one-half of SLE patients will express antiphospholipid antibodies during the course of their disease. The role of prophylaxis with low-dose aspirin is not clear for asymptomatic patients with moderate to high levels of anticardiolipin antibodies but without a history of previous thrombosis. Major thrombosis in these patients requires high-intensity and life-long anticoagulation to prevent recurrence.