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Suggest Treatment For Lupus
Question: I tested positive for the Lupus Like Inhibitor, will Aspirin 325 mg everyday prevent DVT. I have not had DVT but the reason I got tested is because my brother had DVT with PE. I seen my regular doctor and she said no reason to put me on warfarin and for me to take 325 mg of aspirin daily. Is that efficient to prevent clots
Brief Answer:
Lupus anticoagulant
Detailed Answer:
good evening
thank you for writing on health care magic
Well firstly I would like to know how much was the cut off for lupus anticoagulant checked for you? just positive doesn't have much of significance unless the values go towards strongly positive.
Secondly the current recommendation say you need to be positive for 2/out of 3 antibodies. can you check for me if you have been tested for anti cardiolipin antibody and beta2 glycoprotein 1 also? Also check for ANA if it has been done
3. for you to commence treatment or even aspirin. the tests need to be positive twice at least in a period of 3 months. so you can wait on it as well
4. for the dose of aspirin , you need not be on such high dose. recommend dose of 75/mg which can help prevent any clots and even reduce the side effects of bleeding due to aspirin.
to summarize, I feel the treatment has been started prematurely for you. Cause once you start on treatment you will have to take it lifetime. Even if lupus inhibitor is positive and you don't have any clotting history( family history not too significant as it is not transmitted), you can wait for anti platelets. only during long haul flights or any surgeries you have to commence treatment for it and that too low molecular weight heparin.
I hope the information was useful
do let me know these queries
regards
dr naval
Lupus anticoagulant
Detailed Answer:
good evening
thank you for writing on health care magic
Well firstly I would like to know how much was the cut off for lupus anticoagulant checked for you? just positive doesn't have much of significance unless the values go towards strongly positive.
Secondly the current recommendation say you need to be positive for 2/out of 3 antibodies. can you check for me if you have been tested for anti cardiolipin antibody and beta2 glycoprotein 1 also? Also check for ANA if it has been done
3. for you to commence treatment or even aspirin. the tests need to be positive twice at least in a period of 3 months. so you can wait on it as well
4. for the dose of aspirin , you need not be on such high dose. recommend dose of 75/mg which can help prevent any clots and even reduce the side effects of bleeding due to aspirin.
to summarize, I feel the treatment has been started prematurely for you. Cause once you start on treatment you will have to take it lifetime. Even if lupus inhibitor is positive and you don't have any clotting history( family history not too significant as it is not transmitted), you can wait for anti platelets. only during long haul flights or any surgeries you have to commence treatment for it and that too low molecular weight heparin.
I hope the information was useful
do let me know these queries
regards
dr naval
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Attached are my lab results thanks
Brief Answer:
Lab results reviewed
Detailed Answer:
Good evening
I have gone through your results. YOu have been extensively evaluated.
Well, most of your results are negative. So even if you stop aspirin and repeat them after 3 months, you should be good
The only thing which I would suggest is, you get the titres of Lupus like inhibitor in the next blood taking( after 3 months).Eg: . If the lab cut off is 1.1 and you get 1.2 and it is mentioned as positive, it does not hold much significance. On the other hand, say it around 2.0, with a cut of around 1.1, then definite role of Aspirin is indicated. So the titres are mandatory
LAstly, the dose of ASpirin can be kept at around 75 mg which is as good as 325 m since both block platelets irreversibly. So no point of taking such high dose.
To add, as I mentioned before any long haul flight( > 4 hours) or if you ever get posted for surgery, do mention it to your doctors. Some recommendations do include a single shot of low molecular weight heparin before such situations to prevent any clots in the legs
I hope the information was useful
Do let me know for more queries
REgards
Dr Naval
Lab results reviewed
Detailed Answer:
Good evening
I have gone through your results. YOu have been extensively evaluated.
Well, most of your results are negative. So even if you stop aspirin and repeat them after 3 months, you should be good
The only thing which I would suggest is, you get the titres of Lupus like inhibitor in the next blood taking( after 3 months).Eg: . If the lab cut off is 1.1 and you get 1.2 and it is mentioned as positive, it does not hold much significance. On the other hand, say it around 2.0, with a cut of around 1.1, then definite role of Aspirin is indicated. So the titres are mandatory
LAstly, the dose of ASpirin can be kept at around 75 mg which is as good as 325 m since both block platelets irreversibly. So no point of taking such high dose.
To add, as I mentioned before any long haul flight( > 4 hours) or if you ever get posted for surgery, do mention it to your doctors. Some recommendations do include a single shot of low molecular weight heparin before such situations to prevent any clots in the legs
I hope the information was useful
Do let me know for more queries
REgards
Dr Naval
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you so much for the information one other question, how do doctors order for the titers to be check because all the doctor orders is the dRVVT blood test to look for the lupus like inhibitor but no titers are evaluated so how would the lab requisition read to check titers thanks
Brief Answer:
Lupus Anticoagulant
Detailed Answer:
Good evening
Well, there are many methods to check for Lupus like inhibitor. The most specific one is Lupus anticoagulant checked via aPTT. DRVVT is another method of checking, but for exact confirmation it is checked by adding inhibitors to your normal serum to see if it neutralizes. You will have to ask a different lab to carry it out in a different method , other than DRVVT. That would give us the exact value. Maybe a proper immunology lab.
Regards
Dr naval
Lupus Anticoagulant
Detailed Answer:
Good evening
Well, there are many methods to check for Lupus like inhibitor. The most specific one is Lupus anticoagulant checked via aPTT. DRVVT is another method of checking, but for exact confirmation it is checked by adding inhibitors to your normal serum to see if it neutralizes. You will have to ask a different lab to carry it out in a different method , other than DRVVT. That would give us the exact value. Maybe a proper immunology lab.
Regards
Dr naval
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Above answer was peer-reviewed by :
Dr. Sonia Raina
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