Chapter 476 Acquired Inhibitors of Coagulation

Acquired circulating anticoagulants (inhibitors) are antibodies that react or cross react with clotting factors or components used in coagulation screening tests (phospholipids), thereby prolonging screening tests, such as prothrombin time and partial thromboplastin time. Some of these anticoagulants are autoantibodies that react with phospholipid and thereby interfere with clotting in vitro but not in vivo. The most common form of these antiphospholipid antibodies has been referred to as the lupus anticoagulant (Chapter 473). This anticoagulant is found in patients with systemic lupus erythematosus (Chapter 152), in those with other collagen-vascular diseases, and in association with HIV. In otherwise healthy children, spontaneous lupus-like inhibitors have developed transiently after incidental viral infection. These transient inhibitors are usually not associated with either bleeding or thrombosis.

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