Lupus anticoagulant and venous leg ulceration

Background Most leg ulcers occur in patients with venous insufficiency. However, not all patients with venous insufficiency develop leg ulcers. Recent studies have found that factors causing clotting abnormalities, e.g. anticardiolipin antibody (ACA), are associated with leg ulcers. Although lupus anticoagulant, like ACA, belongs to the group of antiphospholipid antibodies, its presence in patients with venous leg ulceration has not been previously reported. Objectives To determine the presence of lupus anticoagulant in patients with venous leg ulceration. Methods We investigated the presence of lupus anticoagulant in 2 7 patients with venous leg ulcers and compared these data with controls. Lupus anticoagulant was evaluated in all subjects by the Russell's viper venom test. Results Of 27 patients with venous leg ulceration, 16 (59%) were shown to have lupus anticoagulant, while only one of 32 controls (3%) was found to have lupus anticoagulant. Thus, lupus anticoagulant was significantly more frequent in patients with venous leg ulcers than in controls (P<0.001). Conclusions We suggest that lupus anticoagulant could be a hitherto unknown factor contributing to the development of venous leg ulcers.