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What is the cause and treatment for clotting disorder?

Q: I was diagnosed with a clotting disorder. I have a positive anti-cardio-lipin. Please give me more information on this.

A:There is a clinical state called antiphospholipid syndrome that is characterised by recurrent venous or arterial thrombosis (blood clot within the arteries or veins) and/or recurrent abortions (in women) associated with typical laboratory abnormalities. The abnormal tests include persistently raised levels of different types of antibodies directed against phospholipids (e.g. anticardiolipin antibody, antibeta-2 glycoprotein) or abnormal clotting tests which confirm the presence of a circulating anticoagulant. These antibodies are often seen in a) people having genetic predisposition; b) common autoimmune or rheumatic diseases (SLE, Sjögren syndrome, rheumatoid arthritis, autoimmune thrombocytopaenic purpura, autoimmune haemolytic anaemia, psoriasis, systemic sclerosis, mixed connective-tissue disease); c) Infections like syphilis, Hepatitis C, HIV, Malaria, septicaemia and d) Drugs - Procainamide, quinidine, propranolol, phenytoin, chlorpromazine, amoxycillin etc. All this results in an alteration in the normal regulation of blood clotting leading to a hypercoagulable state and recurrent thrombosis. The exact mechanism of thrombosis is not yet known. The sites affected could be the extremities and virtually any organ: Peripheral venous system - deep vein thrombosis; Brain – stroke; Blood - thrombocytopaenia, haemolytic anaemia; Obstetric – abortions, hypertension; Lung - pulmonary embolism, pulmonary hypertension; Heart – infarction; Skin; Eyes etc. The American College of Rheumatology has given a set of criteria for the diagnosis and classification of the disease. The treatment is individualized according to the patient's current clinical status and history of prior thrombotic events. Prophylaxis includes eliminating risk factors like oral contraceptive pills, smoking, hypertension, or hyperlipidaemia plus low-dose aspirin (or anti–platelet drug called clopidogrel in patients allergic to aspirin). If a patient has thrombosis, it is treated accordingly as per standard protocols. With appropriate drugs and lifestyle modifications, most people can lead normal, healthy lives but there is a subset of patients who, despite aggressive treatment, continue to have thrombotic events.


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