Antiphospholipid antibodies occur in various clinical states, including the primary antiphospholipid syndrome. Clinical features in these conditions appear to be caused by vasculopathy associated with the presence of these antibodies.. We report the case of a patient with primary antiphospholipid syndrome who experienced cardiac necrosis secondary to myocardial microvasculopathy in the absence of vasculitis. This case demonstrates unequivocally that noninflammatory myocardial microvasculopathy occurs in the primary antiphospholipid syndrome per se without any clinical or immunologic signs of systemic lupus erythematosus or other disease process. The histopathologic findings in the skin and myocardial biopsies showed a noninflammatory vasculopathy characterized by bland thrombi and lack of infiltration of the vessel wall by inflammatory cells. Ultrastructural examination of the myocardial biopsy confirmed the vascular thrombosis and endothelial activation and showed no deposits in basement ...
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OBJECTIVE To determine the prevalence of cardiac valvular involvement in patients with the primary antiphospholipid syndrome. DESIGN Cross-sectional study with evaluation of case patients and control patients by Doppler echocardiography. The mean follow-up for case patients was 22 months. SETTING University-based tertiary medical center. PATIENTS Twenty-eight consecutive patients who were diagnosed with the primary antiphospholipid syndrome during a 10-year period; 28 age- and sex-matched healthy controls. MEASUREMENTS AND MAIN RESULTS Ten patients (36%; 95% Cl, 19% to 56%) with the primary antiphospholipid syndrome had cardiac valvular involvement: Four patients had mitral valve involvement; four patients, aortic valve involvement; and two patients, both mitral and aortic valvular involvement; no patients had tricuspid or pulmonary valve disease. Eight of 10 patients had a regurgitant murmur. None of the control patients had valvular disease. The mean mitral valve thickness in patients with
Antiphospholipid syndrome is an autoimmune disease, in which "antiphospholipid antibodies" (anticardiolipin antibodies and lupus anticoagulant) react against proteins that bind to anionic phospholipids on plasma membranes. Like many autoimmune diseases, it is more common in women than in men. The exact cause is not known, but activation of the system of coagulation is evident. Clinically important antiphospholipid antibodies (those that arise as a result of the autoimmune process) are associated with thrombosis and vascular disease. The syndrome can be divided into primary (no underlying disease state) and secondary (in association with an underlying disease state) forms. Anti-ApoH and a subset of anti-cardiolipin antibodies bind to ApoH, which in turn inhibits Protein C, a glycoprotein with regulatory function upon the common pathway of coagulation (by degradating activated factor V). Lupus anticoagulant (LAC) antibodies bind to prothrombin, thus increasing its cleavage to thrombin, its active ...
Systemic Antiphospholipid Syndrome, Antiphospholipid Syndrome information and help pages for APS patients, doctors and medical professionals Antiphospholipid Syndrome - Systemic Antiphospholipid syndrome (APS) is a disorder characterized by recurrent venous or arterial thrombosis and/or fetal losses associated with typical laboratory abnormalities. These include persistently elevated levels of antibodies directed against membrane anionic phospholipids (ie, anticardiolipin [aCL] antibody, antiphosphatidylserine) or their associated plasma proteins, predominantly beta-2 glycoprotein I (apolipoprotein H), or evidence of a circulating anticoagulant.Multiple terms exist for APS. Unfortunately, some synonyms can be confusing. Lupus anticoagulant (LA) syndrome, for example, is misleading because patients may not ... Antiphospholipid Syndrome - Antiphospholipid syndrome (APS) is a disorder characterized by recurrent venous or arterial thrombosis and/or fetal losses associated with typical laboratory
Systemic Antiphospholipid Syndrome, Antiphospholipid Syndrome information and help pages for APS patients, doctors and medical professionals Antiphospholipid Syndrome - Systemic Antiphospholipid syndrome (APS) is a disorder characterized by recurrent venous or arterial thrombosis and/or fetal losses associated with typical laboratory abnormalities. These include persistently elevated levels of antibodies directed against membrane anionic phospholipids (ie, anticardiolipin [aCL] antibody, antiphosphatidylserine) or their associated plasma proteins, predominantly beta-2 glycoprotein I (apolipoprotein H), or evidence of a circulating anticoagulant.Multiple terms exist for APS. Unfortunately, some synonyms can be confusing. Lupus anticoagulant (LA) syndrome, for example, is misleading because patients may not ... Antiphospholipid Syndrome - Antiphospholipid syndrome (APS) is a disorder characterized by recurrent venous or arterial thrombosis and/or fetal losses associated with typical laboratory
Donadini, MP, Crowther, M. "Antiphospholipid syndrome: a challenging hypercoagulable state with systemic manifestations". Hematol-Oncol. vol. 24. 2010. pp. 669-76. (Recent concise review and update of this syndrome. Many of the clinical statistics were cited from this review.). Ruiz-Irastorza, G, Crowther, M, Branch, W, Khamashta, MA. "Antiphospholipid syndrome". Lancet. vol. 376. 2010. pp. 1498-1509. (Along with the first listed reference, a key source for this chapter, especially with respect to treatment recommendations.). Frances, C. "Dermatological manifestations of Hughes antiphospholipid antibody syndrome". Lupus. vol. 19. 2010. pp. 1071-77. (Current review of cutaneous manifestations.). Weinstein, S, Piette, W. "Cutaneous manifestations of antiphospholipid antibody syndrome". Hematol Oncol Clinics N Am. vol. 22. 2008. pp. 67-77. (Relatively recent review of cutaneous findings.). Hughes, GRV. "Antiphospholipid syndrome (Hughes syndrome): 10 clinical topics". Lupus. vol. 19. 2010. pp. ...
TY - JOUR. T1 - Bioprosthetic mitral valve thrombosis complicating antiphospholipid antibody syndrome, successfully treated with thrombolysis. AU - Chamsi-Pasha, Mohammed A.. AU - Alyousef, Tareq. AU - Sayyed, Samer H. PY - 2014/1/1. Y1 - 2014/1/1. N2 - The incidence of bioprosthetic valve thrombosis and related embolic complications is extremely rare, obviating the need for long-term anticoagulation. As a result, experience in the diagnosis and treatment of bioprosthetic valve thrombosis is fairly limited. We report the first case of antiphospholipid antibody syndrome presenting as bioprosthetic mitral valve thrombosis, 15 months after valve replacement, and successfully treated with thrombolytic therapy. (Echocardiography 2014;31:E278-E281).. AB - The incidence of bioprosthetic valve thrombosis and related embolic complications is extremely rare, obviating the need for long-term anticoagulation. As a result, experience in the diagnosis and treatment of bioprosthetic valve thrombosis is fairly ...
Antiphospholipid antibody syndrome is a fascinatingly complex disorder. It is an autoimmune disease, whereby the immune system attacks our own tissues. This article summarises the basic mechanisms of the condition and main diseases it is involved in. Learn about the diverse effects antiphospholipid antibody syndrome (APS) can have, from heart attack to miscarriage and how APS can be treated.
This guideline reviews the features of the Antiphospholipid syndrome [APS]- definition, clinical association, pathophysiology and the laboratory detection of Antiphospholipid antibodies. It includes a section on who should be tested for aPL antibodies and how this should influence their management. It also includes sections on the management of APS and the Catastrophic Antiphospholipid syndrome [CAPS].. ...
Antiphospholipid Antibody Syndrome (APS) is a highly prevalent cause of antibody-mediated thrombosis manifesting in venous thrombosis (DVT and PE), arterial thrombosis (most commonly stroke), and pregnancy complications. The diagnosis of definite APS requires both clinical and laboratory criterion as established by the working group of the International Congress on Antiphospholipid Antibodies (based on expert opinion). Since thrombosis and pregnancy loss are common in the general population, and antiphospholipid antibodies (aPL) occurs in a small percentage of the healthy public, it is important to demonstrate antibody persistence in patients who have the proper clinical indications in order to avoid misdiagnosis. Unfortunately, laboratory testing in this area lacks standardization, resulting in wide inter-laboratory variance. However, due to the commercialization of tests and automation, inter-laboratory variance has improved. Data on several new non-criterion tests suggest that they may ...
New life-saving treatments for Antiphospholipid syndrome in clinical trial on Genetic Risk Factors Associated With Antiphospholipid Antibody Syndrome
Rationale: Antiphospholipid syndrome (APS) in pregnancy may trigger the life-threatening catastrophic antiphospholipid syndrome (CAPS). Complement activation is implicated in the pathogenesis, and inhibition of complement factor C5 is suggested as an additional treatment option. Patient concerns, diagnosis and interventions: We present a pregnant patient treated with the C5-inhibitor eculizumab due to high risk of developing devastating APS-related complications. The complement inhibitory effects of the treatment were examined both in the patient and the premature infant. Outcomes: Complement activity in the mother recovered considerably faster than anticipated; however, no new thrombosis or CAPS developed during the last week of pregnancy or postpartum. Blood sampling from the umbilical vein and artery, and from the infant after delivery showed low complement activity; however, only 0.3% of the eculizumab concentration detected in the mother, consistent with low placental passage of eculizumab. ...
Sources Used in Current Review. Berg, T. (Updated 2015 April 15). Antiphospholipid syndrome and pregnancy. Medscape. Available online at http://emedicine.medscape.com/article/261691-overview. Accessed 2/15/2017.. (Reviewed 2016 March 21). Antiphospholipid syndrome. Lupus Foundation of America. Available online at http://www.lupus.org/answers/entry/antiphospholipid-syndrome. Accessed 2/15/2017.. Movva, S. (Updated 2016 July 1). Antiphospholipid syndrome workup. Medscape. Available online at http://emedicine.medscape.com/article/333221-workup. Accessed 2/15/2017.. Moake, J. (Revised 2016 September) Antiphospholipid antibody syndrome. Merck Manual Professional Version. Available online at http://www.merckmanuals.com/professional/hematology-and-oncology/thrombotic-disorders/antiphospholipid-antibody-syndrome-aps. Accessed 2/15/2017.. (Updated 2016 December). Antiphospholipid syndrome - APS. ARUP. Available online at http://www.arupconsult.com/Topics/APS.html?client_ID=LTD. Accessed 2/15/2017.. (© ...
TY - JOUR. T1 - IgG/IgM antiphospholipid antibodies present in the classification criteria for the antiphospholipid syndrome: a critical review of their association with thrombosis. AU - Kelchtermans, H.. AU - Pelkmans, L.. AU - de Laat, B.. AU - Devreese, K. M.. PY - 2016/8. Y1 - 2016/8. KW - anti-cardiolipin. KW - anti-phospholipid antibody. KW - antiphospholipid syndrome. KW - (2)-glycoprotein I. KW - IgM. U2 - 10.1111/jth.13379. DO - 10.1111/jth.13379. M3 - Article. VL - 14. SP - 1530. EP - 1548. JO - Journal of Thrombosis and Haemostasis. JF - Journal of Thrombosis and Haemostasis. SN - 1538-7933. IS - 8. ER - ...
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TY - JOUR. T1 - Use of fondaparinux in a patient with antiphospholipid antibody syndrome and heparin-associated thrombocytopenia [9]. AU - Holtan, Shernan G.. AU - Knox, S. K.. AU - Tefferi, Ayalew. PY - 2006/7. Y1 - 2006/7. UR - http://www.scopus.com/inward/record.url?scp=33745225893&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=33745225893&partnerID=8YFLogxK. U2 - 10.1111/j.1538-7836.2006.01961.x. DO - 10.1111/j.1538-7836.2006.01961.x. M3 - Article. C2 - 16839370. AN - SCOPUS:33745225893. VL - 4. SP - 1632. EP - 1634. JO - Journal of Thrombosis and Haemostasis. JF - Journal of Thrombosis and Haemostasis. SN - 1538-7933. IS - 7. ER - ...
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BACKGROUND Antiphospholipid syndrome (APS) is an autoimmune systemic disease characterized by vascular thrombosis (arterial or venous) and/or pregnancy complications associated with the occurrence of autoantibodies, specifically lupus anticoagulant, anticardiolipin antibodies, and/or anti-β2 glycoprotein-I antibodies confirmed at least twice over a 12 week period according to the 2006 Sydney criteria. Antiphospholipid antibodies are encountered in the general population with a reported prevalence of 1% to 5% However, APS is far more infrequent with a prevalence of 40-50/100,000 persons and an incidence of about 5 new patients/100,000 persons. APS can be diagnosed in patients with no apparent clinical or laboratory pathology (primary APS) or it may be related to numerous other conditions, autoimmune diseases (usually systemic lupus erythematosus), malignancies, infections and drugs (secondary APS). Women are at risk for APS since the disease is encountered in both the primary and the secondary state
Pregnancy morbidity is one of the clinical manifestations used for classification criteria of antiphospholipid syndrome (APS). During the 14th International Congress on Antiphospholipid Antibodies (aPL), a Task Force with internationally-known experts was created to carry out a critical appraisal of …
Pathogenic and Therapeutic Role of Vitamin D in Antiphospholipid Syndrome Patients By Svetlana Jelic, Dejan Nikolic, Dragomir Marisavljević and Ljudmila Stojanovich Submitted: November 5th 2015Reviewed: August 2nd 2016 Published: April 26th 2017 DOI: 10.5772/65071 Abstract In this chapter, the novel findings on interrelationship between vitamin D status and two well‐known prothrombotic states, antiphospholipid syndrome, particularly its thrombotic phenotype, and metabolic syndrome will be reviewed. We shall present the results obtained from patients included in Serbian National Antiphospholipid Syndrome Registry, 68 patients with primary antiphospholipid syndrome (PAPS) and 69 patients with antiphospholipid syndrome associated with certain autoimmune rheumatic disease (sAPS), as well as 50 patients with pure metabolic syndrome (MetS). These results will be analysed and compared with the novel literature data. Prevalence of MetS in APS is high, with the atherogenic dyslipidaemia as its most ...
... is characterized by thromboses in the larger arteries and veins and thrombotic microangiopathy. Indications: Suspicion of antiphospholipid syndrome. Thromboembolism in ...
Schmeding and Schneider [57] reviewed the literature from 2000-2010 on the QOL of patients with SLE. It has been shown to lower QOL in patients with SLE vs. patients with other chronic diseases. SLE significantly reduces patients ability to cope with everyday activities. It is conditioned by age, fatigue and coexistence of neurological and psychiatric disorders, depression and irritability. There was no direct correlation between the degree of disease activity and organ damage in SLE and QOL.. Choi et al. [58] evaluated that the QOL of patients with SLE was lower than the control group, consisting healthy people. Reduced QOL resulted in depression, taking GCS and fatigue, which was not the result of the degree of disease activity and organ damage. Understanding psychological problems and appropriate treatment can help to improve the QOL of patients with SLE, especially those taking high doses of glucocorticosteroids, even if the disease activity is low. The study included 108 patients with SLE, ...
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by the presence of antiphospholipid antibodies, such as lupus anticoagulant, anticardiolipin antibodies and anti-β2-glycoprotein 1 antibodies. APS can present with a variety of clinical phenotypes, including thrombosis in the veins, arteries and microvasculature as well as obstetrical complications. The pathophysiological hallmark is thrombosis, but other factors such as complement activation might be important. Prevention of thrombotic manifestations associated with APS includes lifestyle changes and, in individuals at high risk, low-dose aspirin. Prevention and treatment of thrombotic events are dependent mainly on the use of vitamin K antagonists. Immunosuppression and anticomplement therapy have been used anecdotally but have not been adequately tested. Pregnancy morbidity includes unexplained recurrent early miscarriage, fetal death and late obstetrical manifestation such as pre-eclampsia, premature birth or fetal ...
During the past 12 years both clinicians and researchers involved in rheumatology, haematology, clinical immunology, and gynaecology have been inundated with hundreds of manuscripts regarding the so called antiphospholipid syndrome (APS).. As a result of the spread of information about the pathogenesis and clinical aspect of antiphospholipid antibodies (APA) in humans, non-professional APA readers have been often puzzled by APA characterisation, criteria for APS definition, reliability of assays for APA detection, and APS management.. None the less, thanks to the growing number of clinical findings concerning APS, it has became apparent that understanding of this syndrome may be of interest to other medical specialties.. Asherson and colleagues faced the difficult task of going through the great amount of information on APS and to present it in a systematic and didactic way.. The book is homogeneously structured in three sections dealing with aetiopathogenic mechanisms of APS (section I), its ...
Antiphospholipid syndrome is a systemic autoimmune disorder. It is usually defined as the clinical complex of vascular occlusion and ischaemic events occurring in patients who have circulating antiphospholipid antibodies. Pathology Patients hav...
Outcome of primary antiphospholipid syndrome in childhood. Gattorno, M.; Falcini, F.; Ravelli, A.; Zulian, F.; Buoncompagni, A.; Martini, G.; Resti, M.; Picco, P.; Martini, A. // Lupus;2003, Vol. 12 Issue 6, p449 The objective of this paper is to investigate the long-term outcome of primary antiphospholipid syndrome (APS) in the paediatric age. The features of unselected patients with primary APS who had disease onset before the age of 16 years were retrospectively analysed in three Italian referral... ...
The classical clinical picture of the antiphospholipid syndrome (APS) is characterized by venous and arterial thromboses, fetal losses and thrombocytopenia, in the presence of antiphospholipid...
A 32-year-old woman was admitted for mild gait difficulty and behavioural changes of 3 years duration. Familial and medical histories were unremarkable. Neurological examination revealed: mildly slowed gait, decreased synkinesias of the left arm (held abducted and flexed), increased deep tendon reflexes, Babinski signs, mild lower limb spasticity and dysmetria of left limbs. Depression and mild executive dysfunctions were also found.. Brain CT showed cerebral white matter (WM) calcifications (fig 1). MRI revealed T2 WM hyperintensities in the centra semiovalia, around the frontal horns and, to a lesser extent, in the posterior regions. Post-contrast MRI demonstrated points and stripes of enhancement in the periventricular WM, which are consistent with engorged medullary vessels (fig 2). Proton ...
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Blood. 117(25), 6939-6947. Agar C, de Groot PG, Marquart JA & Meijers JCM. (2011b) Evolutionary conservation of the LPS binding site of beta2-glycoprotein I. Thromb Haemost. In press. Arad A, Proulle V, Furie RA, Furie BC & Furie B. (2011) β₂-Glycoprotein-1 autoantibodies from patients with antiphospholipid syndrome are sufficient to potentiate arterial thrombus formation in a mouse model. Blood. 117(12), 3453-3459. Bevers EM & Galli M. (1990) Beta 2-glycoprotein I for binding of anticardiolipin antibodies to cardiolipin. Electron microscopy analysis of β2GPI. , 2010). Analysis of EM pictures showed that more than 99% of plasma β2GPI was in a closed conformation. These observations suggested that plasma β2GPI circulates in a circular (closed) conformation, whereas after interaction with antibodies β2GPI undergoes a major conformational change into a fishhook-like (open) structure. , 1996). When antibodies toward β2GPI were added to plasma, clotting times prolonged in a β2GPI-dependent ...
The antiphospholipid syndrome (APS) is characterised by the presence of antiphospholipid antibodies (aPA) associated with thrombosis (arterial and venous) and pregnancy morbidity. This thesis has aimed to investigate the frequency of protein C pathway defects in patients with aPA and to study clinical correlates examine the mechanisms of antiphospholipid interference in the protein C pathway and to assess activated protein C (APC) resistance in patients with aPA in terms of thrombin generation. Although have I have discovered a high degree of heterogeneity in the phenotype of patients with APS, I have demonstrated APC resistance and increased thrombin generation in the majority of patients with APS. While in some cases, APC resistance is clearly immunoglobulin mediated, it is a multifactorial phenomenon with many confounding variables. My data suggest that immunoglobulin dependent APC resistance may occur through P2 glycoprotein-I dependent and independent mechanisms. In a detailed study of ...
Erkan: Antiphospholipid Syndrome patients with vascular events generally receive life-long anticoagulation, despite the lack of high-quality data on the risk of recurrence and optimal duration of anticoagulation. Given that at least 50% of thrombotic events in aPL-positive patients have recognizable triggers, the possibility of discontinuing anticoagulation in highly selected patients exists, especially when the triggers are eliminated. However, discontinuation of anticoagulation is a critical decision that requires careful assessment of comorbidities, triggers, and residual thrombosis as well as patient education. The 13th International Congress on aPL Treatment Task Force recommended that "in cases of first venous event, low-risk aPL profile, and a known transient precipitating factor, anticoagulation could be limited to 3-6 months." Given the importance of this question, i.e., anticoagulation withdrawal in APS, the development of a multicenter clinical trial protocol to determine whether ...
A look at antiphospholipid antibody syndrome, what laboratory tests can support the diagnosis of this syndrome, what are the causes and how is it treated. ...
This case may be coincidental or it may be that the plasminogen deficiency increased the thrombotic tendency of APS in this patient. , 1996). Biochemistry. 35(43), 1383313842. 3 Genetics of Antiphospholipid Syndrome Jesús Castro-Marrero, Eva Balada, Josep Ordi-Ros and Miquel Vilardell-Tarrés Systemic Autoimmune Diseases Research Unit, Vall dHebron University Hospital Research Institute Universitat Autónoma de Barcelona, Barcelona Spain 1. , 2006). The etiology of APS, however, is still unknown. pdf in Orphanet, INSERM MIM nº 107320). APS can involve almost any organ system, including a wide range of clinical manifestations. , 2008). 2011) Microparticles in hemostasis and thrombosis. Circ Res. 108(10), 1284-1297. Pangburn MK & Rawal N. (2002) Structure and function of complement C5 convertase enzymes. Biochem Soc Trans. 30(Pt 6), 1006-1010. Pennings MT, van Lummel M, Derksen RH, Urbanus RT, Romijn RA, Lenting PJ & de Groot PG. (2006) Interaction of beta2-glycoprotein I with members of the ...
... - also known as Hughes syndrome - is an autoimmune disorder in which the immune system attacks phospholipids.
Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4:295-306. https://doi.org/10.1111/j.1538-7836.2006.01753.x Esteve-Valverde E, Ferrer-Oliveras R, Alijotas-Reig J. Obstetric antiphospholipid syndrome. Rev Clin Esp. 2016;216:135-45. https://doi.org/10.1016/j.rce.2015.09.003 Cervera R, Serrano R, Pons-Estel GJ, Ceberio-Hualde L, Shoenfeld Y, de Ramon E, et al. Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: A multicentre prospective study of 1000 patients. Ann Rheum Dis. 2015;74:1011-8. https://doi.org/10.1136/annrheumdis-2013-204838 Meroni PL, Borghi MO, Raschi E, Tedesco F. Pathogenesis of antiphospholipid syndrome: Understanding the antibodies. Nat Rev Rheumatol. 2011;7:330-9. https://doi.org/10.1038/nrrheum.2011.52 Chighizola CB, Raschi E, Borghi MO, Meroni PL. Update on the pathogenesis and ...
Ann Arbor, MI - For men and women affected with antiphospholipid syndrome (APS), blood thinners are the main treatment option. Unfortunately, treatment with blood thinners does not prevent all cases of blood clotting in APS, says Dr. Jason Knight, an assistant professor of rheumatology at Michigan Medicine. APS is an autoimmune condition characterized by blood clots…
Can dual antiplatelet therapy effectively prevent thrombosis recurrence in patients with antiphospholipid syndrome? How does it compare to warfarin?
Hi, I have often thromboses, so Im taking anticoagulants regularly. Doctors are having trouble diagnosing. Maybe I have antiphospholipid syndrome.
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By Kristin Bendikson, MD. When a woman has a miscarriage, she often feels isolated and alone. Miscarriages are more common than most people realize, however; and when women start talking with their friends, they often find that they are not alone in coping with this difficult experience.. A miscarriage-the early loss of a pregnancy-occurs in approximately 15 percent of all clinically recognized pregnancies. If all pregnancies are accounted for, the statistic is closer to 50 percent ending in a loss. The increase is due to the fact that many women dont even know they are pregnant and experience their period at the normal time or just a few days late. Sometimes a woman knows she is having a miscarriage because she has symptoms, which might include bleeding and cramping followed by the passage of the pregnancy. Other times a woman doesnt sense there is anything wrong at all, and she finds out that the pregnancy has stopped growing only when she sees her doctor for an ultrasound.. Its important ...
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PURPOSE OF REVIEW: Laboratory criteria for the classification of antiphospholipid syndrome include the detection of a lupus anticoagulant and/or anticardiolipin and anti-β2-glycoprotein I antibodies. However, the majority of patients who test positive in these assays do not have thrombosis. Current risk-stratification tools are largely limited to the antiphospholipid antibody profile and traditional thrombotic risk factors. RECENT FINDINGS: Novel biomarkers that correlate with disease activity and potentially provide insight into future clinical events include domain 1 specific anti-β2GPI antibodies, antibodies to other phospholipids or phospholipid/protein antigens (such as anti-PS/PT), and functional/biological assays such as thrombin generation, complement activation, levels of circulating microparticles, and annexin A5 resistance ...
Results Seventy six patients with APS were included: 11 patients with primary APS and 65 patients with secondary APS, with mean disease duration of 9.59±7.39years. Overall,35 patients (46.1%) had neurologic manifestations. Their mean disease duration was 9.2±5.76 years. Seven patients had primary APS and 28 patients had secondary APS. Six patients were on chronic oral anticoagulant therapy and low dose aspirin, 12 patients on oral anticoagulant alone and 15 patients on low dose aspirin. Transient ischemic attack was the first manifestation of APS in 4 patients (11.42%) at mean age of 29.5±10.96 years. Their mean DIAPS value was 7.75±4.19. Ischemic stroke was the first APS manifestation in 12 patients (34.28%) at mean age of 40.08±16.31years, with DIAPS mean value of 7.41±3.67. All of these patients have neurological sequelaes. The DIAPS value was higher in patients with neurologic manifestations (3±2.9 vs 5.71±3.62, p=0.001) and DIAPS value correlated significantly to neurologic ...
RESULTS: Abnormal MR findings were more common in patients with systemic lupus erythematosus with antiphospholipid syndrome (73% versus 53%). Large territorial (P = .01), lacunar (P = .01), localized cortical (P , .01), borderzone infarcts (P , .01), basal ganglia lesions (P = .03), stenotic arterial lesions (P = .04), and the rate of positive findings on MR imaging (P = .01) were significantly associated with antiphospholipid syndrome. Irrespective of age, significantly more patients with antiphospholipid syndrome manifested lacunar infarcts in the deep white matter (P , .01), localized cortical infarcts in the territory of the MCA (P , .01), bilateral borderzone infarcts (P , .01), and anterior basal ganglia lesions (P = .01). ...