ISSN 2997-1036
International Journal of Hematology | Vol. 13, No. 4, April 2022 | pp. 25–32
DOI: 10.46882/2022/IJH/000146
Original Article
Title: Evaluation of baseline plasma antithrombin III functional activity as an independent predictor of thromboembolic risk in lupus nephritis
Names of Authors: E. F. Chinedu¹, G. H. Haruna², I. J. Balogun³
Authors’ Affiliations: ¹Department of Haematology, University of Nigeria Teaching Hospital, Enugu, Nigeria; ²Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Nigeria; ³Department of Chemical Pathology, University of Ilorin, Ilorin, Nigeria
Abstract: Nephrotic-range proteinuria in lupus nephritis induces a severe hypercoagulable state due to the heavy urinary loss of natural regulatory elements, but the clinical utility of functional antithrombin III monitoring remains under-studied. This prospective study evaluated baseline plasma antithrombin III functional activity in 54 adult patients with active Class IV lupus nephritis to track its correlation with serum albumin depletion and 1-year thromboembolic complications. Antithrombin III activity was quantified via chromogenic substrate assays prior to starting high-dose immunosuppressive therapy. Severe antithrombin III activity depletion (< 60.0%) was identified in 29.6% (16 of 54) of the patients. Multivariable Cox proportional hazards regression revealed that baseline antithrombin III activity below 60.0% was an independent predictor of acute deep vein thrombosis or pulmonary embolism within a 12-month follow-up window (hazard ratio = 4.12, P < 0.01). Antithrombin III depression correlated strongly with low serum albumin levels (r = -0.68, P < 0.001) and elevated D-dimer values. Screening for functional antithrombin III profiles provides clear prognostic utility, helping identify high-risk autoimmune renal cohorts requiring early prophylactic anticoagulation.
Keywords: Lupus nephritis, antithrombin III, hypercoagulability, albuminuria, thromboembolism
Manuscript Timeline: Received: January 12, 2022; Revised: February 20, 2022; Accepted: March 08, 2022; Published: April 14, 2022