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Forum Name: Rheumatology Topics

Question: lupus and blood clots


 Maree Stebbings - Tue Aug 10, 2004 7:46 am

Hi, I was diagnosed with SLE in 1998 after my first son was born, then I had trouble conceiving but had another son 4 years later. Since then I have found it to be getting worse. Alot of pain and I seem to have alot of blood problems a high positive to lupus anticoagulant and a high positive for antiphosphoid antibodies, my rheumatologist has recommended that I don't have any more children, what are the risks? How will I know if I get a blood clot? This has scared the hell out of me and I should have liked another child unless something happens I don't get to see my doctor for awhile and he is 600km away and I don't like to ring up with my incessant questions it seems that no sooner do I ask them I have a hundred more - there is just so much to this disease. I am also on antidepressants for reactive depression to this disease but my thyroid levels are always on the border of the lower limit can this have anything to do with the depression? I've heard that it can. I appreciate any answers that anyone can give me!!
Thank You so much
 Dr. Yasser Mokhtar - Tue Aug 10, 2004 9:21 am

User avatar Dear Maree,

Lupus has lots of negative health effects on the body. Antiphospholipid antibodies or lupus anticoagulants have the negative side effects of causing blood clots.

From your profile, it does not look that you have active or severe lupus as you are currently not on any medication for active lupus treatment.

Aspirin is the way to go for anti-phospholipid antibody syndrome without previous history of blood clots.

Your rheumatologist's recommendation of not having any more children is understandable. Pregnancy makes women more prone to blood clots. You are already prone because of your condition and this means higher risk for blood clots than in normal pregnancies. There are other effects of pregnancy on the body that might be caused by lupus and this might give rise to confusion on whether this was caused by lupus or pregnancy.

Pregnancy might cause lupus flares, in the great majority of patients, flares are mild, but in a small minority they are severe.

There is a higher chance of abortion and still births.

There is a higher chance that babies born to mothers with lupus have neonatal lupus.

You will be getting subcutaneous shots of blood thinners all through your pregnancy.

You will have to be watched very closely and diligently during your pregnancy.

i don't think that there is a contraindication to you getting pregnant but you have to understand the associated risks, potential side effects and the things that you will have to endure and that the outcome might not be as favorable.

As for the symptoms of blood clots, it depends on the site of the blood clot. Blood clot can occur either in arteries or veins. If in arteries, usually the area supplied by the artery is deprived of blood supply and subsequently dies (an example is a stroke or a heart attack). If a vein is occluded, there will be enlargement of the organ that this vein drains due to blood engorgement and the consequences depend on the organ involved. The most common veins affected are the veins of the lower extremities and the symptoms produced are pain in the calf or thigh, edema or enlargement of the leg. If the blood clot travels to the lungs it gives rise to shortness of breath and chest pain and a variety of other symptoms depending on the size of the blood clot.

Depression can be caused by lots of medical conditions, i am not sure what you mean by your thyroid functions is on the lower limit of normal. There are two thyroid function tests one is called tsh and the other free-t4.
Which one are you talking about? Because if have an underactive thyroid, the tsh is actually high and the free-t4 is low and vice versa if you have an hyperactive thyroid gland. The standard that we usually go by is the tsh, if it is higher than a certain level and the patient is symptomatic, patient is given thyroid hormones as replacement and the tsh is followed till goes to normal.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped and waiting for any comments or concers.

Yasser Mokhtar, M.D.
 Maree Stebbings - Tue Aug 10, 2004 7:20 pm

No I don't have very severe lupus I was on plaquinel but it didn't agree with me it affected my eyesight so in discussion with my doctor I have chosen not to be medicated at this time this was my choice because at the moment besides the blood problems I am very stable. Thank you so much for you help

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