Re: OCP's and Anticardiolipin antibodies
From: Anna Meenan, MD (annam@uic.edu)
Mon Jul 9 17:16:06 2001
More info: anticardiolipin IgG antibodies: 26 gpl units
Platelets 348,000. Mom tells me today that she has had occasional
episodes in the past where one side of her face goes numb for a few
minutes. I told mom she should not take the pills anymore.
--
Anna Meenan, MD
At Mon, 9 Jul 2001, Anna Meenan, MD wrote:
>
>But if she's never been pregnant and never had a blood clot she can't by
>definition have apa syndrome, and I can't find much that says whether
>COCP's are safe if she just has positive anticardiolipin antibodies and
>nothing else. I've sent for records from the rheumatologist who
>diagnosed her. I'm not sure even what her titer of anticardiolipin ab
>was. My gut feeling is she should not take them (mainly because I would
>not take them if I was her.
>
>--
> Anna Meenan, MD
>
>At Sat, 07 Jul 2001, mark decker wrote:
>>
>>reviewing for boards = the entire compedium front to back - reviewed this
>>last night and reviewed it again for this question today
>>
>>if she has definite positive apa igG antibodies above 15 - 20 gpl units she
>>is then truly positive for the apa -
>>
>>if she had fetal loss, low platelets or thrombosis then she has the syndrome
>>
>>with the antibodies she should still try to avoid pregnancy until truly
>>ready to be pregnant with attendant low dose heparin and baby asa
>>
>>but management of pts with antibody and no pg and no hx of thrombosis ,
>>fetal loss, thrombocytopenia best management is not known -
>>low dose asa suggested.
>>
>>and they say if the syndrome is present estrogen ocp's are contradicted
>>
>>acog bulletins
>>
>>mdmd
>>
>>At 12:49 PM 7/7/2001 -0500, you wrote:
>>>18 y.o young woman in my office yesterday for refill on OCP's. Been on
>>>'em a coupla years with no problems. Takes Desogen because she also has
>>>acne and it helps that. In the past year developed Reynaud's and was
>>>seen elsewhere. Positive family history of Lupus so they tested her for
>>>that. Don't have the results but she says they told her she doesn't
>>>have lupus but she is anticardiolipin positive. Should she continue to
>>>take OCP's? She says the doctor who saw her said it would not be a
>>>problem. Should I switch her to a 1st-generation progesterone even
>>>though her acne will probably get worse?
>>>
>>>--
>>>Anna Meenan, MD, FAAFP
>
