A DISORDER OF BLOOD COAGULATION IN SYSTEMIC LUPUS ERYTHEMATOSUS 12

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Abstract
Blood coagulation mechanism was studied in a series of 43 consecutive patients with systemic lupus erythematosus (LE) whose blood contained the LE cell factor. Twelve of the 43 showed significant aberration. In 7 of these, excess of an anticoagulant substance was shown. Abnormalities in the 5 remaining patients were similar to, but of lesser degree than those found in the 7 patients with demonstrable anticoagulant. The pattern of abnormal coagulation in systemic lupus is as follows: (1) Slightly prolonged whole blood clotting time; (2) prolonged clotting time of platelet-poor recalcified plasma; (3) prolonged one-stage prothrombin time; (4) delayed thrombin generation but normal prothrombin consumption after 1 hour; (5) the presence of a substance capable of delaying the clotting time of normal blood or plasma. In 10 of the 12 patients, the abnormal coagulation could be ascribed to a substance which interfered with the action of thromboplastin, but not with the formation of thromboplastin. In 1, impaired generation of thromboplastin was found, with no interference with the action of preformed thromboplastin. In the 12th patient, it could not be determined whether the anticoagulant activity was due to an antithromboplastin or an antithrombic substance. In only 3 of the 12 affected patients was hemorrhage a prominent symptom, and in only 1 could the bleeding be ascribed solely to the anticoagulant activity. However, the type of clotting disorder found in 10 patients in this series seems to have a high degree of specificity for systemic lupus erythematosus.