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antiphospholipid syndrome and pregnancy

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https://www.readbyqxmd.com/read/27920020/repeated-failed-non-invasive-prenatal-testing-in-a-woman-with-immune-thrombocytopenia-and-antiphospholipid-syndrome-lessons-learnt
#1
C Y Y Hui, W C Tan, E L Tan, L K Tan
We present a case of a 37-year-old Chinese woman (gravida 4 para 0) with a history of immune thrombocytopenia and type IIb antiphospholipid syndrome. She was started on 100 mg of aspirin, 20 mg of prednisolone and 20 mg of subcutaneous low-molecular-weight heparin daily for her fourth pregnancy. She opted for non-invasive prenatal testing for aneuploidy screening but had failed results three times consecutively from insufficient fetal cfDNA initially or high variance in cfDNA counts on redraws. She declined invasive karyotyping...
December 5, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27913749/belimumab-in-primary-antiphospholipid-syndrome
#2
A Yazici, B Yazirli, D Erkan
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by thrombosis and/or pregnancy morbidity with persistently positive antiphospholipid antibodies (aPL). Patients with aPL may also experience thrombocytopenia, cardiac valve disease, nephropathy, skin ulcer, or cognitive dysfunction, which are collectively known as non-criteria manifestations of APS. A description is provided of two primary APS patients who received belimumab (10 mg/kg) for an aPL-related manifestation.
December 2, 2016: Lupus
https://www.readbyqxmd.com/read/27913550/prevention-of-thrombosis-in-antiphospholipid-syndrome
#3
Wendy Lim
Antiphospholipid syndrome (APS) is an acquired autoimmune condition characterized by thrombotic events, pregnancy morbidity, and laboratory evidence of antiphospholipid antibodies (aPL). Management of these patients includes the prevention of a first thrombotic episode in at-risk patients (primary prevention) and preventing recurrent thrombotic complications in patients with a history of thrombosis (secondary prevention). Assessment of thrombotic risk in these patients, balanced against estimated bleeding risks associated with antithrombotic therapy could assist clinicians in determining whether antithrombotic therapy is warranted...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27865435/-the-pulse-mass-index-as-a-predictor-of-cardiovascular-events-in-women-with-systemic-lupus-erythematosus
#4
Elsy Aidé García-Villegas, Horacio Márquez-González, Luis Felipe Flores-Suárez, Antonio Rafael Villa-Romero
BACKGROUND: Patients with systemic lupus erythematosus (SLE) have 3times the risk of death compared to the rest of the population, with cardiovascular events (CVD) being one of the main causes. Índices such as waist-height (W-Ht I), waist-hip (W-Hp I) and pulse-mass (PMI) predict CVD, though the behaviour is unknown in patients with SLE. The aim of this study was to determine the prognostic value of PMI in the development of CVD in premenopausal women with SLE. METHODOLOGY: Cohort study...
November 16, 2016: Medicina Clínica
https://www.readbyqxmd.com/read/27854393/birth-weight-in-live-births-and-stillbirths
#5
L C Y Poon, M Y Tan, G Yerlikaya, A Syngelaki, K H Nicolaides
OBJECTIVE: To establish a normal range of birth weights for gestational age at delivery and to compare the proportion of live births and stillbirths that are classified as small-for-gestational age (SGA) according to our normal range vs that of the INTERGROWTH-21(st) standard. METHODS: The study population comprised 113 019 live births and 437 (0.4%) stillbirths. The inclusion criterion for establishing a normal range of birth weights for gestational age was the live birth of a phenotypically normal neonate ≥ 24 weeks' gestation and the exclusion criteria were smoking and prepregnancy hypertension, diabetes mellitus, systemic lupus erythematosus or antiphospholipid syndrome, pre-eclampsia, gestational hypertension, gestational diabetes mellitus or iatrogenic preterm birth for fetal growth restriction in the current pregnancy...
November 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27829500/a-serum-nuclear-magnetic-resonance-based-metabolomic-signature-of-antiphospholipid-syndrome
#6
Angelica Palisi, Manuela Grimaldi, Paola Sabatini, Paola Montoro, Mario Scrima, Manuela Rodriquez, Anna Maria D'Ursi
Antiphospholipid syndrome (APS) is a rheumatic inflammatory chronic autoimmune disease inducing hypercoagulable state associated with vascular thrombosis and pregnancy loss in women. Cardiac, cerebral and vascular strokes in these patients are responsible for reduction in life expectancy. Timely diagnosis and accurate monitoring of disease are decisive to improve the accuracy of therapy. In the present work, we present a NMR-based metabolomic study of blood sera of APS patients. Our data show that individuals suffering APS have a characteristic metabolomic profile with abnormalities associated to the metabolism of methyl group donors, ketone bodies and amino acids...
January 30, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/27816952/antiphosphatidylserine-prothrombin-antibodies-as-biomarkers-to-identify-severe-primary-antiphospholipid-syndrome
#7
Ariela Hoxha, Elena Mattia, Marta Tonello, Chiara Grava, Vittorio Pengo, Amelia Ruffatti
BACKGROUND: Anti-phosphatidylserine/prothrombin (aPS/PT) antibodies have begun to be considered potentional biomarkers for antiphospholipid syndrome (APS). This cohort study investigate the role of aPS/PT antibodies as a risk factor for severe APS by evaluating the association between those antibodies and clinical/laboratory profiles of APS. METHODS: Plasma/serum samples from 197 APS patients, 100 healthy subjects and 106 patients with autoimmune diseases were collected...
November 7, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/27816347/cerebral-venous-thrombosis
#8
José Manuel Ferro, Patrícia Canhão, Diana Aguiar de Sousa
Cerebral venous thrombosis (CVT) has an incidence of 1.32/100,000/years in high-income countries, and higher in middle- and low-income countries. CVT is more frequent in infants and children young adults and females, especially during pregnancy/puerperium. CVT are now being diagnosed with increasing frequency because of the increased awareness and higher use of magnetic resonance imaging (MR) for investigating patients with acute and subacute headaches and new onset seizures. CVT rarely present as a stroke syndrome...
December 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27803506/role-of-novel-oral-anticoagulants-in-the-treatment-of-antiphospholipid-syndrome
#9
C Whitney White, Angela R Thomason, Katie Boyd
Background: Antiphospholipid syndrome (APS) is an autoimmune disease characterized by thrombosis or pregnancy loss with persistent positive antibodies. Standard treatment for APS with history of thromboembolism is heparin or low-molecular-weight heparin followed by a vitamin K antagonist (VKA). Novel oral anticoagulants (NOACs) could be effective in patients with APS, but none carry indications for treatment related to APS. Clinical Evidence: Five case reports or series with rivaroxaban and dabigatran suggest thrombotic events occur most often in the higher risk population (arterial thrombosis and/or triple positive antibodies) or in patients who had recurrent VTEs on warfarin therapy...
October 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27786332/pathophysiological-insights-into-the-antiphospholipid-syndrome
#10
Karl J Lackner, Davit Manukyan, Nadine Müller-Calleja
The antiphospholipid syndrome (APS) is characterized by venous and/or arterial thrombosis and severe pregnancy morbidity in presence of antiphospholipid antibodies (aPL). While there is compelling evidence that aPL cause the clinical manifestations of APS, the underlying mechanisms are still a matter of scientific debate. This is mainly related to the broad heterogeneity of aPL. There are three major types of aPL: The first one binds to (anionic) phospholipids, e.g. cardiolipin, in absence of other factors (cofactor independent aPL)...
October 27, 2016: Hämostaseologie
https://www.readbyqxmd.com/read/27776934/the-antiphospholipid-syndrome-in-patients-with-systemic-lupus-erythematosus
#11
Guillermo J Pons-Estel, Laura Andreoli, Francesco Scanzi, Ricard Cervera, Angela Tincani
The antiphospholipid syndrome (APS) is an autoimmune disease characterized by the occurrence of venous and/or arterial thrombosis and pregnancy morbidity in the presence of pathogenic autoantibodies known as antiphospholipid antibodies (aPL). APS may be associated with other diseases, mainly systemic lupus erythematosus (SLE). The presence or absence of SLE might modify the clinical or serological expression of APS. Apart from the classical manifestations, APS patients with associated SLE more frequently display a clinical profile with arthralgias, arthritis, autoimmune hemolytic anemia, livedo reticularis, epilepsy, glomerular thrombosis, and myocardial infarction...
October 21, 2016: Journal of Autoimmunity
https://www.readbyqxmd.com/read/27770664/clinical-implications-of-the-detection-of-antibodies-directed-against-domain-1-of-%C3%AE-2-glycoprotein-1-in-thrombotic-antiphospholipid-syndrome
#12
Silmara Montalvão, Priscila Soares Elídio, Sabrina da Silva Saraiva, Bruna de Moraes Mazetto, Marina Pereira Colella, Erich Vinícius de Paula, Simone Appenzeller, Joyce Annichino-Bizzacchi, Fernanda Andrade Orsi
INTRODUCTION: Antibodies directed against domain 1 of β2 glycoprotein 1 (aβ2GP1-Dm1) have been involved in the immunopathogenesis of antiphospholipid syndrome (APS). However, the clinical relevance of aβ2GP1-Dm1 in thrombotic APS has not yet been fully explored. OBJECTIVES: To determine the frequency of aβ2GP1-Dm1 in a cohort of patients with thrombotic APS, and to evaluate whether testing for aβ2GP1-Dm1 could have a clinical impact upon the risk assessment of the disease...
October 4, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27756248/the-impact-of-unrecognized-autoimmune-rheumatic-diseases-on-the-incidence-of-preeclampsia-and-fetal-growth-restriction-a-longitudinal-cohort-study
#13
Arsenio Spinillo, Fausta Beneventi, Elena Locatelli, Vèronique Ramoni, Roberto Caporali, Claudia Alpini, Giulia Albonico, Chiara Cavagnoli, Carlomaurizio Montecucco
BACKGROUND: The burden of pregnancy complications associated with well defined, already established systemic rheumatic diseases preexisting pregnancy such as rheumatoid arthritis, systemic lupus erythematosus or scleroderma is well known. Systemic rheumatic diseases are characterized by a long natural history with few symptoms, an undifferentiated picture or a remitting course making difficult a timely diagnosis. It has been suggested that screening measures for these diseases could be useful but the impact of unrecognized systemic rheumatic disorders on pregnancy outcome is unknown...
October 18, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27753626/a-unique-antiphospholipid-assay-recognizing-phospholipid-mixture-compared-with-criteria-antiphospholipid-immunoassays-in-lupus-patients
#14
Y Zuo, R Willis, E Papalardo, M Petri, E N Harris, A Schleh, K DeCeulaer, M Smikle, L M Vilá, J D Reveille, G S Alarcón, E B Gonzalez
BACKGROUND: While essential for the classification of antiphospholipid syndrome (APS), anticardiolipin (aCL) assays lack specificity and anti-β2glycoproteinI (anti-β2GPI) assays lack sensitivity in this regard. Our aim was to perform a comparative analysis of the APhL ELISA assay (IgG/IgM) and criteria antiphospholipid (aPL) immunoassays in identifying APS-related clinical manifestations in a large group of patients with systemic lupus erythematosus (SLE). METHODS: Serum samples from 1178 patients from the Hopkins (n = 543), LUMINA (n = 588) and Jamaican SLE cohorts (n = 47) were examined for IgG/IgM positivity in aCL (in-house), anti-β2GPI (two commercial kits) and APhL (Louisville APL) ELISA assays...
October 16, 2016: Lupus
https://www.readbyqxmd.com/read/27743141/double-positivity-of-the-igg-isotype-of-both-anticardiolipin-and-anti-%C3%AE-2gpi-antibodies-is-associated-with-the-highest-number-of-vascular-impairment-parameters-in-patients-with-primary-antiphospholipid-syndrome-preliminary-data
#15
Mirjana Bećarević, Duško Mirković, Svetlana Ignjatović
Although numerous studies investigated the association between homocysteine (Hcy), tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP) and apolipoproteins (apos) with thrombosis and/or recurrent pregnancy losses, studies that analyzed the abovementioned parameters and multiple positivity of antiphospholipid antibodies (aPL Abs) in patients with primary antiphospholipid syndrome (PAPS) are lacking. Therefore, the aim of this study was to analyze the presence of various combinations of the abovementioned parameters and their associations with clinical and/or serological features of PAPS...
October 14, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27708976/the-clinical-significance-of-antiphospholipid-antibodies-in-systemic-lupus-erythematosus
#16
Ozan Ünlü, Stephane Zuily, Doruk Erkan
Antiphospholipid syndrome (APS) is the association of thrombosis and/or pregnancy morbidity with antiphospholipid antibodies (aPL). Thirty to forty percent of systemic lupus erythematosus (SLE) patients are tested positive for aPL, which may have an impact on the SLE presentation, management, and prognosis. Compared with SLE patients without aPL, those with aPL have a higher prevalence of thrombosis, pregnancy morbidity, valve disease, pulmonary hypertension, livedo reticularis, thrombocytopenia, hemolytic anemia, acute/chronic renal vascular lesions, and moderate/severe cognitive impairment; worse quality of life; and higher risk of organ damage...
June 2016: Eur J Rheumatol
https://www.readbyqxmd.com/read/27704162/tnf-alpha-and-annexin-a2-inflammation-in-thrombotic-primary-antiphospholipid-syndrome
#17
REVIEW
Mirjana Bećarević
Antiphospholipid syndrome (APS) is characterized by thromboses and/or pregnancy losses. Laboratory criterion for the diagnosis of APS is the presence of antiphospholipid antibodies (anticardiolipin, anti-beta2-glycoprotein I (aβ2gpI) and lupus anticoagulant). On the one hand, the latest classification criteria for the diagnosis of APS emphasized that thrombotic manifestations of the syndrome should be without any signs of an inflammatory process, while on the other hand, some recent reports have suggested that APS is a "pro-inflammatory state...
December 2016: Rheumatology International
https://www.readbyqxmd.com/read/27671837/maternal-cardiovascular-function-at-35-37-weeks-gestation-relation-to-maternal-characteristics
#18
Gavin P Guy, Hua Z Ling, Paula Garcia, Liona C Poon, Kypros H Nicolaides
OBJECTIVE: To examine the possible effects of maternal characteristics and obstetric and medical history on maternal cardiovascular parameters at 35-37 weeks' gestation. METHODS: In 3,013 singleton pregnancies at 35-37 weeks maternal characteristics and medical history were recorded; uterine artery pulsatility index, mean arterial pressure (MAP) and maternal cardiovascular parameters were measured. Multivariable regression analysis was used to determine significant predictors of the cardiovascular parameters amongst gestational age (GA), maternal characteristics and medical history...
September 27, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27645511/ep17-21-uterine-artery-doppler-and-triple-marker-positivity-for-the-detection-of-adverse-pregnancy-outcome-in-primary-antiphospholipid-syndrome
#19
I Nicoli, S Zatti, N Fratelli, V Azzaretto, A Vitucci, C Cavalli, G Mazzoni, C Maggi, C Zanardini, F Prefumo, A Lojacono
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27638930/annals-express-antiphospholipid-and-antioangiogenic-activity-in-women-with-recurrent-miscarriage-and-antiphospholipid-syndrome
#20
H Fabián Pelusa, Eleonora Pezzarini, Cecilia Basiglio, Jorge Musuruana, Mariela Bearzotti, María José Svetaz, Stella Maris Daniele, Hebe Bottai, Sandra M M Arriaga
BACKGROUND: Antiphospholipid syndrome (APS) is an autoimmune disease characterized by thrombosis, fetal losses and thrombocytopenia associated to antiphospholipid (APL) antibodies (Abs). They are directed to phospholipids, such as cardiolipins (a-cardiolipin, ACA) and lupus anticoagulant (LA), or to complexes formed by phospholipids and protein cofactors, such as β2 glycoprotein 1 (a-β2GP1) and annexin V (a-annexin V). These auto Abs may be considered as a family of Abs involved in thrombotic events and APL activity...
September 16, 2016: Annals of Clinical Biochemistry
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