PO039-MON Persistent lupus anticoagulant in clinical settings other than antiphospholipid syndrome

REMOTTI L; GROSSO SH; INGRATTI M; VERA MORANDINI M; BERMEJO EI; SÁNCHEZ LUCEROS A; MESCHENGIESER SS; LAZZARI MA; BLANCO AN

Toronto

Congreso; XXV Congress of the International Society on Thrombosis and Haemostasis and 61st Annual SSC Meeting.; 2015

International Society on Thrombosis and Haemostasis

Background: Lupus anticoagulant (LA) can be present in asymptomatic subjects or patients with clinical symptoms other than antiphospholipid syndrome (APS).Aims: In order to assess the presence and persistence of LA in subjects with or without clinical criteria for APS (APScc), a 3 year retrospective analysis (2014?2011) was done. Patients with APScc and subjects with other pathologies or LA+ tests were included. All LA+ were reevaluated (after > 12 weeks).Methods: Subjects: 263 individuals were included; 211 (APSC) had at least one APScc, 52 (NO-APSC) were tested because they had pathologies possibly associated with LA (33) or LA+ results (19). Laboratory: routine tests (PT,TT), sensitive APTT and dRVVT were done; mixing/confirmatory tests were carried out on prolonged tests.Results: LA+ (SSC-ISTH criteria) was detected in 185 subjects (142 APSC and 43 NO-APSC) (1st study). Among NO-APSC, LA+ was seen in bleeders (10/43), asymptomatic subjects (family history of bleeding or thrombosis) (9/43) and other pathologies (24/43) (infertility: 15; chronic renal failure on haemodialysis:7; coronary arterial disease: 2).The 2nd study showed persistent LA in 100/211 APSC (47.4%) and 33/52 NO-APSC (63.5%), including 8/10 bleeders, 6/9 asymptomatic and 19/24 subjects with ?other? manifestation (infertility: 5 had transient LA). Interestingly 8/33 (24.2%) were bleeders; 5/8 had other abnormal tests that maybe would explain their symptoms (platelets dysfunction:2; hyperfibrinolysis:1; low FXI:1; low Fg + low platelet count:1).Among APSC, 42/142 became LA- in the 2nd study; 19/42 were considered transient LA (LA- in a 3rd study) and 23/42 require a 3rd evaluation in order to define persistence.Conclusion: Persistent LA is a frequent finding in asymptomatic subjects and in patients with bleeding history. A careful analysis of laboratory results should be done, even if the diagnosis of an haemorrhagic disorder is not always achieved.