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    What do my blood test report indicate?

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Posted on Sun, 30 Jul 2017 in Blood Disorders
Question: Big Knee op 21/3/17. After 3 days Got provoked Dvt .
Prescribed rivaoxaban - Dvt bit slow to clear , a bit of venal hypertension , wearing a calf stocking - dvt has cleared / leg looks normal . me and haematologist want to stop rivaoxaban but me cautious as leg seems to "fill " a bit if immobile but no external swelling or great pain . In the interim every 3 years i have a kidney blood tests ( but creatine stable over 10 years 110 to130 ) but this time tested -ANA - and tested positive for SLE - ( titre 1:320 speckled).
Question - my haematologist was going to release me from rivsoxabsn after 3 months . When i tell her about sle positive reading will / should that change the plan to come off rivaoxaban ? Or Will she be happy for me to come off rivaoxaban for say two weeks and then test for my propensity to clot - or test for hughes syndrome etc ? What would you do ?
doctor
Answered by Dr. Hardik Sanghvi 47 minutes later
Brief Answer:
You should tested for Anti phospholipid antibodies.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.

You have history of deep vein thrombosis and now you have SLE. So there is high chance of anti phospholipid antibody syndrome (hughes syndrome).

Criteria for anticoagulation treatment is different for each category like with hughes syndrome or without hughes syndrome.

So in my opinion you should continue your rivoxaban treatment as per advice. First go for testing for Anti phospholipid antibodies and then plan accordingly.

Hope I have answered your question.
If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Hardik Sanghvi 14 hours later
To test for anti phospholipid antibody - do i have to stop taking rivaoxaban for a while ?

Is testing my suseptibility to thrombosis the same as testing for hughes syndrome

Do either of these conditions make it more likely i coukd have a stroke ?

Should i take asprin as well - i fear a stroke more thsn anything
doctor
Answered by Dr. Hardik Sanghvi 5 hours later
Brief Answer:
No need to stop rivoxaban.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.

No need to stop rivoxaban. Anti phospholipid syndrome is synonymous of hughes syndrome. For that anti phoantibodies should be tested.

You have high chance of thrombotic events then general population. But if you have hughes syndrome then it increase the chance further. Moreover you need to maintain your INR accordingly. So you should go for testing.

You have high tendency of blood clot. It can occurs anywhere in body. It can leads to stroke, deep vein thrombosis, myocardial infarction or other clotting disease.

But don't worry if you maintain your INR in proper range then we can prevent this.

Continue your aspirin according to advise.

Hope I have answered your question.
If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Hardik Sanghvi 1 hour later
I am not currently taking asprin and thinking perhaps i should start ?
Are the the following statements correct :

Statement 1 If i do not have hughes syndrome - no need to start asprin. As Stroke etc are from arteries and -i only have a vein problem

Statement 2 if tests show i do have hughes syndrome i should stsrt taking asprin

Statemen3 if i have hughes syndrome is it obvious / importsnt thst should protect myself by taking something else other than asprin

Statement 4 there might be a delay of 4 weeks before taking the anti pho antibodies test . In the interim i should itake asprin ( as well as rivaoxaban) ?
doctor
Answered by Dr. Hardik Sanghvi 20 hours later
Brief Answer:
Explained in detail.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.

1. You have high risk of blood clotting. It can occur in arteries or veins anywhere. Right now you have clot in vein but it can occur in arteries also.

2. If you have hughes syndrome then your have to maintain high INR. By your anticoagulant.

3. If you have hughes syndrome then you have to take other anticoagulant other than aspirin.

4. in interim period you can take rivoxaban. Don't start aspirin without advice.

If you not taking aspirin then don't take without consulting your treating doctor. For a week continue your treatment according to his prescription. After testing plan accordingly.

Hope I have answered your question.
If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Hardik Sanghvi 2 hours later
1. I will go quickly to a clinic for a hughes syndrome test . What is the precise name of the test to ask for and are there preparations , like fasting before the test (or just stopping rivaxaban for the test )

2. Does everyone who has hughes syndrome also have SLE ? Can a person have hughes but not SLE?
3 . My positive SLE test was via ANA -see results in earlier email . Could that result be a false positive given on rivaoxaban?
doctor
Answered by Dr. Hardik Sanghvi 22 hours later
Brief Answer:
No any special preparation required.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.

1. You should go for antiphospholipid antibody test & anti cardiolipin antibody test.

2. All patients with hughes syndrome may not have SLE. Person may have hughes syndrome without SLE also.

3. You have positive SLE test with ANA immunofluorescence but it is just a screening test. It should be confirmed by ANA profile. It can be false positive but in your case titer is high so chance of false positive ANA is low. It is also wise to go for ANA profile once.

Hope I have answered your question.
If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by : Dr. Kampana
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Dr. Hardik Sanghvi

Hematologist

Practicing since :2008

Answered : 7039 Questions

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