Would you start anticoagulation in a patient with provoked blood clot in the past now with labs done for rheumatological reasons showing triple positive APLA?
If so, would you start immediately or wait for the second set of labs to confirm before initiating blood thinners?
Answer from: at Academic Institution
The short answer is that I would probably not anticoagulate this patient as a history of prior thrombosis is hard to connect to the currently positive APL antibodies. I would certainly obtain a second set for future risk stratification.
However, there are several variables that could influenc...
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Answer from: at Academic Institution
Triple-positive APL labs are hard to ignore, especially a positive lupus anticoagulant (LAC). As above commented on, there are additional questions to ask: does the patient have lupus or similar systemic autoimmune disorder, is she on estrogens and/or a smoker, what was the initial "provoking" incid...
Answer from: at Community Practice
With a history of a PROVOKED thrombosis (and I would explore this in great detail to be assured that this historical feature is true), I would not. Education about how to AVOID clots on long trips or having to sit for prolonged periods of time is crucial here. I would also explore possible features ...