Behaviour of lupus anticoagulant and PAI_1 activity in young patients affected from ischemic stroke

Suppl.XIII, 1991

ABSTRACTS

46 91

LtiPUSANTICOAGULANT !i_iri:iTS RELEI'GNCEIN ATP ANliiii TiiFtGtlicGTiC SI'NDRiiHE. G.ierrarl,tl.6.Mazzucconi,f. Graponl,G.Cn~stolini~~,G.~i Prlma*~C.Masala~~F.Mandeii~.Hematolo~y-Deu.of Human Sap&a" Home.tInst.MaiattleTroolcail-Univ. "La Sapienia"kome.

tilopathoiogy+niv."La

We refer our experienceabout iG in oatientsaffectedby ATF and/or thrombotlcsyndroae.Thirteenoatlents !F ll,MZ;age1?-40 yrs,med. 34 yrsj affectedby GTP with LA presence iKiT test; const:tutethe first studiedgrouo.In7 anti-cardiolioln antibodiesiGCii were aiso present,inY GNG were found.Nonemet HRG criteriafor SLE diagnosis.Four patients referreda historyof soontaneousrepeatedabortion.onea CVT post-surgery.At time of study, 5 subjectshad normal oits count,4 had pits. between 1513and 50nifi91,ii belou %hlO?'i:lO were taringPDN.one PGN and a:athioprine.Gne patientwas previouslysplenectomized, 1: patients IF ?,M 4:age 3i-%,med,4Syrs,were referred to our attentionfor a tiistory of venous and/or arterialthrombosisilC ctsi or for soontaneousrepeatedabortions i3 otsi. Durq the screeningtest for thrombosis,all of them showed evidenceof LA.& were positive in 13;no patientwas affectedby SLE. Protein C (P.C! and ProteinS it'.Si were evaiuatedin both groups of patients.F.C was normai In all GTP oatierkwhile it was reouced i-2 tiid1,52 Uidii in two istancesof the thromboohilla-aoortlon group. In 4 BTF ate. icr:levelsof free P.S i51-54U/d11 were found. Totai P.S.at normal leveis in 12 cases, aooeared**educed in i case (61 Uidi:. Ir: thromboohiiia-abcrtion ~&free F.S was redureo in 5 iZ-58 Wdlj and in 2 of tile latter total P.S also (5i.55 LVdl).in A? grout 24 ots with reduced free P.S had a historyof soontaneous abortion. in throrboohilia-abortion grouo a normaii:ationof P.S was obtained in one case after.PDNtherapy,and after ;Irolonged anticoagulanttnerapy in anothercase. In all pts with low P.C and P.5 levels,a genetic defect was enciuded.Presence of LA and/or GCL is freouentiyassociatedwith an acouireddefect of P.5 and/or F,C. This interestingfindingcould contributeto better clarify the so-tailed"LA-SYNDROME".

92 BEHAVIOUR PATIENTS

OF LUPUS AFFECTED

ANTICOAGULANT FROM ISCHEMIC M. ,Quintarelli

AND PAI__I

Ferro D., Saliola Previous reports described the presence of lupus anticoamlant had suffered fran cerebral ischanic vascular disease. levels of tissue plasminogen activator thra&tic

ACTIVITY

STROKE. C.,Alessandri

inhibitor

C.,

IN

YOUNG

Violi

(LA) in sare m

F.. patients,

who

In a precedent study, we found hi&

(PAI 1) in LA patients with history of

episodes. The aim of this study was to evaluate the presence of LA and the behaviax

of PAI 1 activity

in young patients with a history of stroke. We studied 20 patients (15 males,

5 females, age 24-52) who suffered

fran ischemic stroke at least three months before the study,

diagnosed by canputerized tomography. ‘Ihe presence of LAwas assessed by three coagulation tests, Kaolin clotting time (KCT;ref.val. 65”),dilute Russel’s viper vencm time (m;ref.val. 30”), and dilute aPIT, previously shoAn to be sensitive to LA. Dilute aPIT was considered abnormal if the difference between I:80 and I:5 ‘Ihrc&ofax dilutions was>15 seconds. PAI 1 activity was measured by a chrarogenic substrate (Coaset PAI, KAE%IVITRI&l; ref.val. The positivity

8.ti3.9

of LA was found in 5 patients , two of them wzre affected

U/ml>;

fran systemic lupus

erythematosus. These 5 patients had PAI activity levels significantly higher, canpared than other 15 patients without LA (24.528.5 VS. 13.9i9.5; dO.025). PAI activity of ischemic patients LA negative didn’t differ

significantly

fran 20 controls,

matched for age and sex.

lhe study shcws the presence of LA associated to hi,& levels of PAI activity affected

frw stroke. lhis susests

mediated by alterations

in young patients

that in these patients LA could represent a risk factor,

of fibrinolytic

system.