Variability in the international normalised ratio (INR) in patients with antiphospholipid syndrome and positive lupus anticoagulant: Should the INR targets be higher?

We present the case of a 34-year-old woman with a history of antiphospholipid syndrome with triple positivity for antiphospholipid antibodies, who had multiple thrombotic events, predominantly pulmonary embolic events, despite treatment with enoxaparin. She is currently on warfarin, with which she h...

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Autores:
Tipo de recurso:
Fecha de publicación:
2015
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
eng
OAI Identifier:
oai:repository.urosario.edu.co:10336/23590
Acceso en línea:
https://doi.org/10.1136/bcr-2014-209013
https://repository.urosario.edu.co/handle/10336/23590
Palabra clave:
Enoxaparin
Lupus anticoagulant
Phospholipid antibody
Prothrombin complex
Rivaroxaban
Warfarin
Anticoagulant agent
Enoxaparin
Lupus anticoagulant
Warfarin
Adult
Anemia
Antiphospholipid syndrome
Article
Bleeding
Case report
Deep vein thrombosis
Drug treatment failure
Endarterectomy
Erythrocyte transfusion
Female
Food drug interaction
Hematuria
Human
International normalized ratio
Laboratory test
Lung embolism
Oxygen therapy
Patient compliance
Priority journal
Pulmonary hypertension
Thrombosis
Treatment duration
Upper gastrointestinal bleeding
Antiphospholipid syndrome
Blood
Chemically induced
Complication
Hematuria
Hemorrhage
International normalized ratio
Pulmonary embolism
Standards
Thrombosis
Treatment outcome
Adult
Anticoagulants
Antiphospholipid syndrome
Enoxaparin
Female
Hematuria
Hemorrhage
Humans
International normalized ratio
Lupus coagulation inhibitor
Pulmonary embolism
Thrombosis
Treatment outcome
Warfarin
Rights
License
Abierto (Texto Completo)
Description
Summary:We present the case of a 34-year-old woman with a history of antiphospholipid syndrome with triple positivity for antiphospholipid antibodies, who had multiple thrombotic events, predominantly pulmonary embolic events, despite treatment with enoxaparin. She is currently on warfarin, with which she has been adequately controlled most of the time, presenting with only one haemorrhagic event consisting of haematuria and prolonged international normalised ratio (INR) without bleeding. This kind of patient represents a challenge for clinicians, particularly due to INR therapeutic targets, which should be higher than recommended in other patients due to the lupus anticoagulant positivity.