"Lupus" anticoagulant and thrombosis--possible role of inhibition of prostacyclin formation.

A "lupus" anticoagulant was discovered in 14 patients over a one year period. Only three of them had systemic lupus erythematosus. Bleeding manifestations were only present in one patient with concomitant severe thrombocytopenia. In contrast, eight patients had a history of thrombosis; five of them presented repeated thrombotic episodes. Obstetrical complications (recurrent abortion, fetal death, or intrauterine growth retardation) were observed in six patients. An inhibitory effect of plasma on the production of prostacyclin by vascular tissue was detected in eight patients, six of whom had thrombosis. We suggest that inhibition of prostacyclin formation could play a major role in the pathogenesis of thrombosis and obstetrical problems in some patients with this type of anticoagulant, even in the absence of systemic lupus erythematosus.