ISSN 2997-1036
International Journal of Hematology | Vol. 5, No. 7, July 2014 | pp. 49–56
DOI: 10.46882/2014/IJH/000055
Original Article
Title: Association of plasma lupus anticoagulant with structural target organ damage in primary antiphospholipid syndrome
Names of Authors: Y. Z. Ibrahim¹, A. B. Okafor², C. D. Danjuma³
Authors’ Affiliations: ¹Department of Haematology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria; ²Department of Pathology, University of Ibadan, Ibadan, Nigeria; ³Department of Haematology, University of Maiduguri, Maiduguri, Nigeria
Abstract: Primary antiphospholipid syndrome causes thrombosis and pregnancy complications without an underlying connective tissue disease. This study evaluated the specific association between persistent plasma lupus anticoagulant positivity and structural target organ damage, including ischemic stroke, renal microangiopathy, and valvular heart defects, in 44 patients with primary antiphospholipid syndrome. Lupus anticoagulant was identified using the diluted Russell’s viper venom time confirmation index, while target organ damage was assessed via magnetic resonance imaging, renal function panels, and transthoracic echocardiography. Persistent lupus anticoagulant positivity was documented in 54.5% (24 of 44) of the patients. Patients with persistent lupus anticoagulant demonstrated a significantly higher prevalence of multi-focal ischemic white matter lesions on brain imaging compared to those with isolated anticardiolipin antibodies (41.6% versus 10.0%, P < 0.05). Furthermore, a significant positive correlation was found between lupus anticoagulant confirmation ratios and the severity of chronic renal insufficiency (r = 0.48, P < 0.01). Persistent lupus anticoagulant is a high-risk indicator for microvascular tissue injury and progressive target organ damage in primary antiphospholipid variants, requiring aggressive, long-term therapeutic anticoagulation.
Keywords: Antiphospholipid syndrome, lupus anticoagulant, thrombophilia, ischemic stroke, microangiopathy
Manuscript Timeline: Received: April 14, 2014; Revised: May 20, 2014; Accepted: June 08, 2014; Published: July 15, 2014