Tarr et al identified risk factors for thrombotic complications in a patient with systemic lupus erythematosus and antiphospholipid antibodies. These can help identify patients who may benefit from more aggressive management. The authors are from the University of Debrecen (Hungary) and Tel-Aviv University.
Patient selection: SLE
Antiphospholipid antibodies included:
(1) lupus anticoagulant
(2) anticardiolipin antibodies
(3) anti-beta-2 glycoprotein
Parameters:
(1) type of antiphospholipid antibodies present
(2) levels of antiphospholipid antibodies
(3) history of thrombosis
(4) anticoagulation therapy
(5) comorbid conditions associated with thrombosis (cancer, infection, hematologic disorders, certain drugs, etc)
Parameters |
Findings |
Points |
lupus anticoagulant |
absent |
0 |
|
present |
1 |
types of antiphospholipid antibodies present |
1 |
0 |
|
2 or more |
1 |
levels of antiphospholipid antibodies |
low or intermittent |
0 |
|
constant high levels |
1 |
history of previous thrombosis |
absent |
0 |
|
present |
1 |
anticoagulant therapy |
none |
0 |
|
present |
1 |
comorbid conditions |
none |
0 |
|
present |
1 |
where:
• A lupus patient can develop thromboses despite anticoagulation therapy. Moderately intense anticoagulation therapy may be as effective as a more intense regimen. Low-dose aspirin therapy can be effective in these patients.
total number of risk factors =
= SUM(points for all of the parameters)
Interpretation:
• A person with no risk factors is at low risk for thrombosis.
• A person with multiple risk factors present may be at high risk for thrombosis.
Specialty: Hematology Oncology, Clinical Laboratory, Immunology/Rheumatology