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Abnormal prothrombin crossed-immunoelectrophoresis in patients with lupus
inhibitors
JR Edson, JM Vogt and DK Hasegawa
Prothrombin deficiency has been known to occur in association with lupus
inhibitors for over 25 years. We studied 21 patients with lupus inhibitors
and found that four of five with prothrombin deficiency and ten of 16 with
quantitatively normal prothrombin had abnormal prothrombin
crossed-immunoelectrophoresis (CIEP) characterized by material moving
slower in the first dimension of electrophoresis than normal prothrombin.
In two patients with prothrombin deficiency, all prothrombin measured by
quantitative assay and all slow-moving material on CIEP were removed by
treatment with Staphylococcal protein A (SPA). These patients had free
antibody, which bound to normal plasma prothrombin, forming larger amounts
of slow-moving material on CIEP. A third patient with prothrombin
deficiency had only partial removal of prothrombin after SPA treatment. Two
patients with quantitatively normal prothrombin had all slow-moving
material on CIEP and about one fourth of the prothrombin by quantitative
assay removed by SPA treatment. There was no correlation among the strength
of the inhibitor, the presence of a "cofactor effect," and the prothrombin
abnormality. These data suggest that heterogeneous antiprothrombin
antibodies, with or without prothrombin deficiency, are present in the
majority of patients with lupus inhibitors.
Volume 64,
Issue 4,
pp. 807-816,
10/01/1984
Copyright © 1984 by The American Society of Hematology
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