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Blood, 1960, Vol. 15, No. 2, pp. 212-227.
© 1960 American Society of Hematology, Inc.
A Plasma Coagulation Defect in Systemic Lupus
Erythematosus Arising from Hypoprothrombinemia
Combined with Antiprothrombinase Activity
SAMUEL I. RAPAPORT 1,
SARA BETH AMES 1, and
BARBARA J. DUVALL 1
1 Department of Medicine, University of Southern California School of Medicine,
and the Pediatric Service, Los Angeles County General Hospital, Los Angeles, Calif.
A patient has been described with systemic lupus erythematosus and severe
bleeding. Her bleeding was associated with a complex plasma coagulation
disturbance consisting of profound hypoprothrombinemia plus an anticoagulant active against formed blood and tissue prothrombinase. The problem of the recognition of hypoprothrombinemia in the presence of this type
of anticoagulant has been discussed in detail.
An analysis of previously reported cases reveals that our patient’s findings
are not unique. It appears that the plasma coagulation disturbances of
systemic lupus erythematosus characteristically result from a mixture of
anticoagulant activity and true hypoprothrombinemia. In an individual patient
one or the other may predominate.
Submitted on April 7, 1959
Accepted on July 1, 1959
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