Date of download: 9/18/2016 From: Monitoring Warfarin Therapy in Patients with Lupus Anticoagulants Ann Intern Med. 1997;127(3):177-185. doi:10.7326/0003-4819-127-3-199708010-00001.

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Bruised Black and Blue: Acquired Hypoprothrombinemia
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Date of download: 9/18/2016 From: Monitoring Warfarin Therapy in Patients with Lupus Anticoagulants Ann Intern Med. 1997;127(3): doi: / Coagulation cascade showing the coagulation reactions of the activated partial thromboplastin time, the dilute Russell viper venom time, the prothrombin time, and the prothrombin-proconvertin time.[15, 16]Phospholipid-dependent reactions (PL) include activation of factor X to factor Xa by factor VIIa-tissue factor (extrinsic factor X-ase complex), the activation of factor X by factor IXa in the presence of factor VIIIa and calcium ions (intrinsic factor X-ase complex), and the activation of prothrombin by factor Xa in the presence of factor Va and calcium ions (prothrombinase complex). Antiphospholipid antibodies have been shown to interfere in vitro with the activation of factor X by the intrinsic factor X-ase complex and the activation of prothrombin by the prothrombinase complex. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

Date of download: 9/18/2016 From: Monitoring Warfarin Therapy in Patients with Lupus Anticoagulants Ann Intern Med. 1997;127(3): doi: / International normalized ratios of 16 patients (designated by L) who had lupus anticoagulants and were receiving warfarin and 10 patients (designated by N) who did not have lupus anticoagulants and were receiving warfarin.The ratios were obtained by using eight different thromboplastins (white square = Dade Innovin, black square = Simplastin Excel, white triangle = Dade Thromboplastin C Plus, black triangle = Simplastin Excel S, white circle = Dade Thromboplastin IS, black circle = Simplastin, white diamond = MDA Simplastin L, and black diamond = Sigma thromboplastin). Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

Date of download: 9/18/2016 From: Monitoring Warfarin Therapy in Patients with Lupus Anticoagulants Ann Intern Med. 1997;127(3): doi: / Therapeutic and nontherapeutic results obtained by using the prothrombin-proconvertin time, chromogenic factor X, and factor II assays and by using international normalized ratios.white circleValues are for 16 patients who had lupus anticoagulants and were receiving warfarin. The results of the prothrombin-proconvertin time and chromogenic factor X assays are compared in the left panel, results of the factor II and chromogenic factor X assays are compared in the middle panel, and the international normalized ratios obtained by using Simplastin Excel S (black square) and Dade Thromboplastin IS ( ) and results of the chromogenic factor X assay are compared in the right panel. The horizontal and vertical lines mark the following therapeutic ranges for the individual assays: prothrombin-proconvertin time, 9% to 27%; chromogenic factor X, 11% to 42%; factor II, 5% to 35%; and international normalized ratio, 2 to 3.5. Values for the factor II, chromogenic factor X, and the prothrombin-proconvertin time assays are the percentage of control pooled plasma activity. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

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