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.
