Andes W A
Thromb Res. 1982 Sep 15;27(6):703-12. doi: 10.1016/0049-3848(82)90008-1.
The effects of an IgM lupus anticoagulant on coagulation tests and factor VIII related antigen (FVIIR:Ag) were investigated on a 62 year old man with lymphocytic lymphoma. He experienced no abnormal bleeding despite a prothrombin time of 29 seconds, PTT 84 seconds and inhibition of multiple coagulation factors. One course of chemotherapy induced a clinical response, normalization of coagulation studies and a rapid fall in IgM from 1120 to less than 30 mg%. Studies revealed a monoclonal IgM, immediate-acting lupus anticoagulant. This IgM could not be shown to affect normal FVIIIR:Ag but the patient's FVIIIR:Ag was grossly abnormal on crossed immunoelectrophoresis with a normal and a rapidly-migrating peak. The anodal component disappeared after chemotherapy. These studies suggest that the anticoagulant was temporally related to but did not cause the abnormality in FVIIIR:Ag. Such antibodies may occasionally serve as disease markers and may point out the disparity between coagulation tests and hemostasis.
对一名62岁淋巴细胞淋巴瘤男性患者，研究了IgM型狼疮抗凝物对凝血试验及因子VIII相关抗原（FVIIR:Ag）的影响。尽管其凝血酶原时间为29秒、部分凝血活酶时间为84秒且多种凝血因子受到抑制，但他并未出现异常出血。一个疗程的化疗诱导了临床反应，凝血研究结果正常化，IgM迅速从1120降至低于30mg%。研究显示存在一种单克隆IgM，即速发型狼疮抗凝物。该IgM未显示对正常FVIIIR:Ag有影响，但在交叉免疫电泳中，患者的FVIIIR:Ag明显异常，出现一个正常峰和一个快速迁移峰。化疗后阳极成分消失。这些研究提示，抗凝物与FVIIIR:Ag异常在时间上相关，但并非其病因。此类抗体偶尔可作为疾病标志物，并可能提示凝血试验与止血之间的差异。
