LUPUS ANTICOAGULANT AS A PROGNOSTIC MARKER IN SYSTEMIC LUPUS ERYTHEMATOSUS

To evaluate the prognostic significance of lupus anticoagulant(LA), 37 SLE patients with LA and 37 age- and sex-matched SLEpatients without LA were followed up for a median of 22 years,of which 16 years (median) after the initial LA-testing. Deepvenous thrombosis was observed in 20 (54%) patients with LA.Of these patients, 90% had the first episode within 8 yearsafter the onset of SLE symptoms, as compared to only one ofthe six LA-negative patients with deep venous thrombosis (P0.0001). Cerebral artery occlusions were more common in patientswith LA (P 0.016), but typically appeared as a late phenomenon.Nephritis or neuropsychiatric manifestations, previously associatedwith a poor outcome in SLE, did not correlate with the presenceof LA. However, higher mortality was associated with both LA(P 0.021) and a history of deep venous thrombosis (P 0.004),as well as with nephritis (P 0.038). The most common cause ofdeath in both LA positives and negatives was vascular occlusion. In conclusion, it appears that the first episode of deep venousthrombosis in patients with LA is typically seen early in thecourse of disease, and that LA and a history of deep venousthrombosis are both associated with increased mortality. KEY WORDS: Antiphospholipid antibodies, Lupus anticoagulant, Lupus erythematosus, Survival, Thrombocytopenia, Thrombosis