Lupus anticoagulant and thrombosis: role of von Willebrand factor multimeric forms

Clin Exp Rheumatol. Jan-Feb 1997;15(1):5-10.

Abstract

Objective: Patients with lupus anticoagulant (LA) have an increased incidence of venous and arterial thrombosis whose pathogenesis is still unclear. High molecular weight von Willebrand Factor (vWF) multimers seem to play a causal role in shear stress-induced platelet aggregation and thrombus formation. We studied whether in patients with LA, alterations in the vWF multimers might coexist.

Methods: The multimeric composition of plasma vWF was analysed by SDS-electrophoresis and immunoblotting in 43 subjects positive for LA. About 2/3 of the patients had had either ischemic stroke, recurrent abortions, deep vein thrombosis (DVT) or a combination of these; the remaining subjects had never had any thrombotic events.

Results: An abnormal vWf multimeric pattern was found in 16 patients (37.2%); no correlation was found with the diagnosis, but the presence of abnormal vWF significantly correlated with the site of the thrombosis: indeed, it was never detected in subjects with DVT, but was found in 71.4% of patients with multiple abortions, in 50% of those with stroke and even in 25% of non-thrombotic patients.

Conclusion: The hypothesis is put forward that abnormal VWF may represent an additional risk factor to LA for arterial thrombosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Habitual / blood
  • Adolescent
  • Adult
  • Aged
  • Arteries
  • Cerebrovascular Disorders / blood
  • Chemical Phenomena
  • Chemistry, Physical
  • Electrophoresis, Polyacrylamide Gel
  • Female
  • Humans
  • Immunoblotting
  • Lupus Coagulation Inhibitor / blood*
  • Male
  • Middle Aged
  • Molecular Weight
  • Pregnancy
  • Thrombosis / blood*
  • von Willebrand Factor / analysis
  • von Willebrand Factor / chemistry*
  • von Willebrand Factor / physiology*

Substances

  • Lupus Coagulation Inhibitor
  • von Willebrand Factor