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Topics:
Internal Medicine • Rheumatology • Hematology • Antiphospholipid Syndrome • Benign Hematology
How would you counsel a patient with active SLE on treatment, low to moderate level of one of the APLS antibodies, and remote history of provoked blood clot regarding perioperative anticoagulation?
Is SLE-related APLS managed differently in terms of anticoagulation?
Answer from: at Academic Institution
Without knowing more specific details, my approach would be to repeat the full panel of antiphospholipid antibodies, institute treatment with HCQ if not there already, discontinue all estrogen products and counsel the patient against smoking. I would coordinate perioperative anticoagulation with a h...
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Answer from: at Academic Institution
In addition to Dr. @Gonzalez's recommendations, I would recommend postoperative prophylaxis with LMWH for 6 weeks. However, to properly assess the risk, I would want to know if the remote thrombosis was provoked or unprovoked and what were the provoking factors if any. I would also want to know if t...