Bleeding, while rare in SLE, can occur under the following conditions:
- Thrombocytopenia, which is found in up to about 20-25% of LA patients
- A functional platelet disorder, possibly because of medications, in particular, due to anticoagulant/antiplatelet drugs
- Obstetrical complications can result in incomplete abortions causing patients to have hemorrhagic events
A very rare event is lupus anticoagulant-hypoprothrombinemia syndrome (LAHS). This is caused by an acquired factor II deficiency, produced by anti-prothrombin antibodies, and lupus anticoagulant. Clinically, patients will present with a bleed and prolonged screening tests that do not correct with a mixing study. Factor II levels can range from between <1% to 25%.
