Anticoagulants circulants Les conditions cliniques du diagnostic

Godeau, P; Blëtry, O.; Piette, Jean‐Charles; Wechsler, B.

doi:10.1016/s0248-8663(85)80035-7

Cited by 11 publications

(2 citation statements)

References 109 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They induce prolongation of phospholipid-dependent clotting times such as partial thromboplastin time (PTT) and prothrombin time (PT). These LA occur in a variety of diseases [6], essentially in autoimmune and lymphoproliferative disorders. They are not 0 1991 Wiley-Liss, Inc. associated with a bleeding tendency but, paradoxically, they can be associated with an increased tendency to arterial and venous thrombosis, which is present in 30% of the cases.…”

Section: Introductionmentioning

confidence: 99%

Lupus anticoagulant associated with primary malignant lymphoplasmacytic lymphoma of the spleen: A report of four patients

Ciaudo¹,

Mh²,

Audouin³

et al. 1991

American J Hematol

View full text Add to dashboard Cite

Primary lymphoma of the spleen is characterized by predominant splenomegaly. Lymphoplasmacytic malignant lymphoma of the spleen, of low malignancy in the Kiel classification, low and intermediate grade in the National Cancer Institute Working Formulation (NCIWF), is rare. It is often associated with a monoclonal immunoglobulin M (IgM). Four patients presenting with primary splenic lymphoma of plasmacytic type associated with a high level of monoclonal IgM and a lupus anticoagulant (LA) are described. This association has not previously been reported. In contrast with the usual heterogeneity of LA, this LA is relatively homogeneous with an important prolongation of the prothrombin time (greater than 18 sec for a control of 12), more prolonged partial thromboplastin time (PTT) of the mixture patient + control plasma than PTT of the patient plasma. Despite the important coagulation abnormalities, none of these four patients has presented any hemorrhagic or thrombotic complications, even during major surgery such as splenectomy. The lupus-like anticoagulant effect ran parallel with the monoclonal IgM. Survival, after splenectomy and chemotherapy, appears to be favourable: three patients are alive with survivals of greater than or equal to 7 years. The follow-up is as yet too short for the last patient.

show abstract

Section: Introductionmentioning

confidence: 99%

Lupus anticoagulant associated with primary malignant lymphoplasmacytic lymphoma of the spleen: A report of four patients

Ciaudo¹,

Mh²,

Audouin³

et al. 1991

American J Hematol

View full text Add to dashboard Cite

show abstract

“…They are divided into two sub-groups of unequal importance and different clinical expression: the first consists of antibodies directed against a single coagulation factor which generally expose to hemorrhagic accidents. The second group includes antibodies directed against a phase of coagulation which expose rather to accidents of thrombosis [ 12 ] .The acquired factor VIII inhibitors has been reported in 4 cases of MM with hemorrhagic manifestations; 2 men and 2 women, aged 43 to 70 years with a mean age of 57.25 ± 11 years, presenting hemorrhagic manifestations and two of these patients died [ 7 – 10 ](Table 2 ).The coexistence of MM and the acquired coagulation inhibitor to factor II was found in a 52-year-old patient with hemorrhage and whose clinical course was complicated by death [ 11 ] (Table 2 ).The fibrino formation inhibitors were observed in two cases of myeloma; in the first one, these inhibitors were responsible for severe bleeding that contributed to the death of the patient and in the second case of IgD myeloma with hypercalcemia, the inhibitors disappeared with the first chemotherapy course [ 12 ].The Willebrand factor Inhibitors were also found in 6 cases of monoclonal gammopathies of undetermined significance, 4 cases of Waldenstrom macroglobulinemia and 1 case of MM [ 13 ] (Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

Rare and unusual case of anti-factor XI antibodies in patient with plasma cell leukemia

et al. 2018

View full text Add to dashboard Cite

BackgroundThe acquired inhibitors of coagulation have been observed in very rare cases of monoclonal gammopathies. We report a very rare case of anti-factor XI antibodies in patient with plasma cell leukemia (PCL).Case presentationThis is a 59-year-old male patient without pathological history, admitted to the nephrology department for management of renal insufficiency and anemia syndrome. The history and physical examination revealed stigmata of hemorrhagic syndrome including hemothorax and hemoptysis. The hemostasis assessment showed an isolated prolonged activated partial thromboplastin time (APTT) with APTT ratio = 2.0.The index of circulating anticoagulant (37.2%) revealed the presence of circulating anticoagulants. The normalized dilute Russell viper venom time ratio of 0.99 has highlighted the absence of lupus anticoagulants. The coagulation factors assay objectified the decrease of the factor XI activity corrected by the addition of the control plasma confirming the presence of anti-factor XI autoantibodies. In addition, the blood count showed bicytopenia with non-regenerative normocytic normochromic anemia and thrombocytopenia. The blood smear demonstrated a plasma cell count of 49% (2842/mm3) evoking PCL. The bone marrow was invaded up to 90% by dystrophic plasma cells. The biochemical assessment suggested downstream renal and electrolyte disturbances from exuberant light chain production with abnormalities including hyperuricemia, hypercalcemia, elevated lactate dehydrogenase, non nephrotic-range proteinuria and high level of C reactive protein. The serum protein electrophoresis showed the presence of a monoclonal peak. The serum immunofixation test detects the presence of monoclonal free lambda light chains. He was treated with velcade, thalidomide and dexamethasone. The patient died after 2 weeks despite treatment.ConclusionBoth PCL and anti-factor XI inhibitors are two very rare entities. To the best of our knowledge, this is the first reported case of a factor XI inhibitor arising in the setting of PCL. Factor inhibitors should be suspected in patients whose monoclonal gammopathies are accompanied by bleeding manifestations.

show abstract