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Monday, January 26, 2015
Test for Lupus Factor???
I`m a 56 y/o w.m. My 50 y/o sister and her daughter have both recently experienced serious blood clots in their legs. A specialist performed the following tests on them: LUPUS factor, protein c an s antiphosphlipids, factor 5 liden antithrombin 3 antibodies and homocystine levels. They both tested + for LUPUS FACTOR and I`m told will probably be on coumidin the rest of their lives. Question: Our father died of a heart attack at age 51, his brother at 41. Could this clotting problem have been a FACTOR in these early deaths? How does the + test result and the clots relate to Lupus per se, and is the problem familial? The big question -- should I be tested for these problems even though I`ve never experienced any problems (although neither did my sister until 50)? Can you shed any light on this? Thanks a lot for your insights!!!
Patients with `Anti-phospholipid Syndrome` usually have one or more of the following: episodes of thrombosis in arteries or veins, recurrent abortions, or low platelet count, with positive tests for `Lupus anti-coagulant`, VDRL and/or anti-cardiolipin antibodies.
Sometimes, the thrombosis can occur without any other associated illness - it is then called `primary anti-phospholipid syndrome`. Sometimes, these symptoms and tests can occur in patients who have other autoimmune diseases (such as `lupus` and other connective tissue diseases); certain drugs, chronic infections, including HIV can also sometimes cause these symptoms and tests. Collectively, the latter group of patients are referred to as having `secondary anti-phospholipid syndrome`. All patients with thrombosis should undergo testing for lupus and enquired about drug intake and infections.
Generally, if the thrombosis is seen in more than one family member, it is considered to be due to inherited defects in production of Factor V Leiden, Protein C, protein S, antithrombin III, homocysteine. There have been a few case reports where anti-phospholipid syndrome occurred in more than one family member. Based on my experience in other autoimmune diseases, I expect the incidence of familial anti-phospholipid syndrome to be about 10-25%.
Ram Raj Singh, MD
Associate Professor of Clinical Medicine
College of Medicine
University of Cincinnati