Monitoring Warfarin Therapy in Patients with Lupus Anticoagulants

Letters15 March 1998Monitoring Warfarin Therapy in Patients with Lupus AnticoagulantsArmando D'Angelo, MD, Patrizia Della Valle, PhD, and Luciano Crippa, MDArmando D'Angelo, MDScientific Institute H.S. Raffaele; 20132 Milano, ItalySearch for more papers by this author, Patrizia Della Valle, PhDScientific Institute H.S. Raffaele; 20132 Milano, ItalySearch for more papers by this author, and Luciano Crippa, MDScientific Institute H.S. Raffaele; 20132 Milano, ItalySearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-6-199803150-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Moll and Ortel report that the use of the international normalized ratio (INR) to standardize prothrombin times is invalid for some patients with lupus anticoagulants, who should be individually monitored with a test that is insensitive to lupus anticoagulants [1]. Their conclusions support our suggestion that monitoring of oral anticoagulation with prothrombin time in patients with lupus anticoagulants should be performed at high plasma dilutions to avoid unnecessary excessive anticoagulation for patients who may have major bleeding complications [2]. In a series of 10 patients with persistent lupus anticoagulants and venous thromboembolic disease who had been treated ...References1. Moll S, Ortel TL. Monitoring warfarin therapy in patients with lupus anticoagulants. Ann Intern Med. 1997; 127:177-85. Google Scholar2. Della Valle P, Crippa L, Safa O, Tomassini L, Pattarini E, Vigano' D'Angelo S, et al. Potential failure of the international normalized ratio (INR) system in the monitoring of oral anticoagulation in patients with lupus anticoagulants. Ann Med Interne. 1996; 147(Suppl 1):10-4. Google Scholar3. Owren PA, Aas K. The control of dicoumarol therapy and the quantitative determination of prothrombin and proconvertin. Scand J Clin Lab Invest. 1951; 3:201-8. Google Scholar4. Simioni P, Prandoni P, Zanon E, Saracino MA, Scudeller A, Villalta S, et al. Deep venous thrombosis and lupus anticoagulant. A case–control study. Thromb Haemost. 1996; 76:187-9. Google Scholar5. Lockshin MD. Answers to the antiphospholipid-antibody syndrome? N Engl J Med. 1995; 332:1025-7. Google Scholar Author, Article, and Disclosure InformationAffiliations: Scientific Institute H.S. Raffaele; 20132 Milano, Italy PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 March 1998Volume 128, Issue 6Page: 504KeywordsAnticoagulant therapyAnticoagulantsBlood plasmaHemorrhageInternational normalized ratioProthrombin timeResearch laboratoriesVenous thromboembolism Issue Published: 15 March 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...