Lupus anticoagulant-hypoprothrombinemia syndrome: report of two cases and review of the literature

Lupus. 2015 Jun;24(7):736-45. doi: 10.1177/0961203314558859. Epub 2014 Nov 12.

Abstract

Lupus anticoagulant-hypoprothrombinemia syndrome (LA-HPS) is a rare acquired disorder caused by prothrombin antibodies. The disease is most common in the pediatric age group (<16 years), and more prevalent in women. There are well-established clinical diseases associated with LA-HPS, most notably systemic lupus erythematosus (SLE) and viral infections. The clinical manifestation of LA-HPS varies greatly in severity and it may cause severe life-threatening bleeding diathesis. LA-HPS is to be suspected when a patient presents with bleeding and a prolonged activated partial thromboplastin and prothrombin time, in combination with a lupus anticoagulant. The diagnosis is confirmed in the laboratory by identification of reduced prothrombin levels. There are no standardized recommendations for treatment of the hemorrhage associated with the syndrome; corticosteroids are used as first-line treatment. This review summarizes what is currently known about the pathogenesis, clinical features, diagnosis, treatment and prognosis of LA-HPS, and presents two case reports.

Keywords: Lupus anticoagulant; acquired hypoprothrombinemia; antiprothrombin antibodies; bleeding; hypoprothrombinemia; prothrombin.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antibodies, Antiphospholipid / blood
  • Antiphospholipid Syndrome / blood*
  • Child, Preschool
  • Female
  • Humans
  • Hypoprothrombinemias / blood*
  • Lupus Coagulation Inhibitor / blood*
  • Lupus Erythematosus, Systemic / blood*
  • Male

Substances

  • Antibodies, Antiphospholipid
  • Lupus Coagulation Inhibitor

Supplementary concepts

  • Acquired hypoprothrombinemia