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Antiphospholipid in obstetric patient

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https://www.readbyqxmd.com/read/28915160/current-insights-in-obstetric-antiphospholipid-syndrome
#1
Karen Schreiber, Massimo Radin, Savino Sciascia
PURPOSE OF REVIEW: Antiphospholipid syndrome (APS) is defined as the association of thrombotic events and/or obstetric morbidity in patients persistently positive for antiphospholipid antibodies (aPL). In this review, we will highlight the most important clinical presentations of APS with a focus on the obstetric morbidity, the current management strategies and the outlook for the future. RECENT FINDINGS: The use of aspirin and heparin has improved the pregnancy outcome in obstetric APS and approximately 70% of pregnant women with APS have a successful pregnancy outcome...
September 14, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28829758/catastrophic-antiphospholipid-syndrome-ronald-asherson-syndrome-and-obstetric-pathology
#2
Alexander D Makatsariya, Jamilya Khizroeva, Viktoriya O Bitsadze
BACKGROUND: Catastrophic antiphospholipid syndrome (CAPS) is an uncommon, often fatal, variant of the antiphospholipid syndrome (APS) that results in a widespread coagulopathy and high titres of antiphospholipid antibodies (aPL) and affects predominantly small vessels supplying organs with the development of multiorgan failure. It remains unclear why some patients develop the typical clinical picture of APS (thrombosis of large vessels), whereas others show the development of progressive microthrombosis, which the authors called "thrombotic storm" and multiple organ failure, that is, CAPS...
August 22, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28748519/obstetric-antiphospholipid-syndrome-and-long-term-arterial-thrombosis-risk
#3
Genady Drozdinsky, Eran Hadar, Anat Shmueli, Rinat Gabbay-Benziv, Shachaf Shiber
Antiphospholipid syndrome (APS) is classified as the association of a thrombotic event and/or obstetric morbidity in patients persistently positive for antiphospholipid antibodies and/or lupus anticoagulant. To evaluate the incidence of subsequent thrombosis among women diagnosed with purely obstetric APS. We retrospectively reviewed and collected demographic and clinical data from the computerized charts of all patients with obstetric APS, from 1992 to 2017. Eligibility criteria included all women diagnosed with APS, according to the 2006 revised criteria, for whom the clinical manifestations were purely obstetric...
July 26, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28680464/-to-test-or-not-to-test-the-arguments-for-and-against-thrombophilia-testing-in-obstetrics
#4
REVIEW
Laura Ormesher, Louise E Simcox, Clare Tower, Ian A Greer
Clinicians increasingly investigate women for thrombophilias due to their associations with venous thromboembolism and placenta-mediated pregnancy complication. These associations, however, are modest and based largely on retrospective data from studies with heterogeneous classifications and populations, leading to discordance between evidence and guidelines. Current evidence suggests a contributory rather than causative role for thrombophilia in placenta-mediated pregnancy complication and venous thromboembolism...
June 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28647939/non-criteria-or-seronegative-obstetric-antiphospholipid-syndrome
#5
REVIEW
Luis J Jara, Gabriela Medina, Polita Cruz-Cruz, Javier Olivares-Rivera, Carolina Duarte-Salazar, Miguel A Saavedra
Obstetric antiphospholipid syndrome (Obs-APS) is one of the most commonly identified causes of recurrent pregnancy loss and its accurate diagnosis is a requirement for optimal treatment. Some patients do not fulfill the revised Sapporo classification criteria, the original APS classification criteria, and are considered to be non-criteria Obs-APS. In these patients with non-criteria, there is controversy about their inclusion within the spectrum of APS and eventually their treatment as having Obs-APS. A subset of patients may also have clinical characteristics of Obs-APS even though lupus anticoagulant (LA), anticardiolipin antibodies, and anti-β2-glycoprotein I (aβ2GPI) antibodies are consistently negative...
June 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28576307/serological-evolution-in-women-with-positive-antiphospholipid-antibodies
#6
Leyre Riancho-Zarrabeitia, Germán Daroca, Pedro Muñoz, Marcos López-Hoyos, Ana Haya, Víctor M Martínez-Taboada
OBJECTIVES: To explore the clinical and serological course of fertile women with positive antiphospholipid (aPL), and the factors and therapeutic implications associated with aPL negativization. METHODS: Retrospective study including 105 women with a positive aPL serology between 1995 and 2013 attending the obstetric autoimmune pathology clinic of a tertiary facility. Patients were classified into the following 3 groups: patients with primary antiphospholipid syndrome (pAPS, 49), patients with a positive serology for aPL, not meeting clinical criteria (42), and patients with systemic lupus erythematosus and a positive aPL serology (14)...
May 10, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28572466/longterm-outcome-of-patients-with-primary-antiphospholipid-syndrome-a-retrospective-multicenter-study
#7
Mara Taraborelli, Rossella Reggia, Francesca Dall'Ara, Micaela Fredi, Laura Andreoli, Maria Gerosa, Ariela Hoxha, Laura Massaro, Marta Tonello, Nathalie Costedoat-Chalumeau, Patrice Cacoub, Franco Franceschini, Pier Luigi Meroni, Jean Charles Piette, Amelia Ruffatti, Guido Valesini, Eon Nigel Harris, Angela Tincani
OBJECTIVE: To assess the longterm frequency of thrombotic recurrences, obstetrical complications, organ damage, severe comorbidities, and evolution toward connective tissue disease (CTD) in primary antiphospholipid syndrome (PAPS). METHODS: Medical records of patients with PAPS followed in 6 centers for ≥ 15 years were retrospectively reviewed. RESULTS: One hundred fifteen patients were studied: 88% women, followed between 1983 and 2014 with a mean (± SD) age at diagnosis of 33 (± 10) years...
August 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28532221/antiphospholipid-antibodies-are-associated-with-positive-screening-for-common-mental-disorders-in-women-with-previous-pregnancy-loss-the-noha-psy-observational-study
#8
Jean-Christophe Gris, Fabienne Cyprien, Sylvie Bouvier, Eva Cochery-Nouvellon, Géraldine Lavigne-Lissalde, Erick Mercier, Jean-Pierre Balducchi
OBJECTIVES: Case reports describe neuropsychiatric manifestations associated with antiphospholipid antibodies (aPlAbs). In patients sharing the same symptoms fulfilling the antiphospholipid syndrome (APS) clinical criteria, the prevalence of common mental disorders has, however, never been studied. METHODS: We observed women with three consecutive abortions before the 10th week of gestation or one foetal loss at or beyond the 10th week. We compared the prevalence of common psychiatric disorders detected through screening using the Mini International Neuropsychiatric Interview, 10 years after inclusion, in women with APS (n = 506), women negative for aPlAbs but carrying the F5rs6025 or F2rs1799963 thrombogenic polymorphism (n = 269), and women with negative thrombophilia screening results as controls (n = 764)...
June 19, 2017: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/28476065/extracellular-vesicles-in-the-antiphospholipid-syndrome
#9
Shruti Chaturvedi, Ravi Alluri, Keith R McCrae
Antiphospholipid antibodies (aPL), particularly those directed against β2-glycoprotein I, cause activation of vascular cells (endothelial cells, platelets, monocytes) and release of extracellular vesicles (EVs), which include exosomes and microparticles (MPs). MPs, particularly endothelial MPs, have been most extensively studied in antiphospholipid syndrome (APS). Compared with healthy controls, patients with aPL have significantly higher levels of circulating endothelial and platelet MPs, including MPs expressing immunological and functional tissue factor...
May 5, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28473138/antiphospholipid-syndrome-role-of-vascular-endothelial-cells-and-implications-for-risk%C3%A2-stratification-and-targeted-therapeutics
#10
REVIEW
Michel T Corban, Ali Duarte-Garcia, Robert D McBane, Eric L Matteson, Lilach O Lerman, Amir Lerman
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by venous thromboembolism, arterial thrombosis, and obstetric morbidities in the setting of persistently positive levels of antiphospholipid antibodies measured on 2 different occasions 12 weeks apart. Patients with APS are at increased risk for accelerated atherosclerosis, myocardial infarction, stroke, and valvular heart disease. Vascular endothelial cell dysfunction mediated by antiphospholipid antibodies and subsequent complement system activation play a cardinal role in APS pathogenesis...
May 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28471597/women-s-issues-in-antiphospholipid-syndrome
#11
Emmanouil Papadakis, Anastasia Banti, Anna Kioumi
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...
September 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28467291/clinical-associations-of-proinflammatory-cytokines-oxidative-biomarkers-and-vitamin-d-levels-in-systemic-lupus-erythematosus
#12
R Willis, M Smikle, K DeCeulaer, Z Romay-Penabad, E Papalardo, P Jajoria, B Harper, V Murthy, M Petri, E B Gonzalez
Background The abnormal biological activity of cytokines plays an important role in the pathophysiology of both systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). Several studies have highlighted the association of vitamin D and certain pro-inflammatory cytokines with disease activity in SLE. However, there are limited data on the association of vitamin D and antiphospholipid antibodies (aPL) with various proinflammatory biomarkers in these patients and their relative impact on clinical outcomes...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28424481/the-first-genome-wide-association-study-identifying-new-susceptibility-loci-for-obstetric-antiphospholipid-syndrome
#13
Mayumi Sugiura-Ogasawara, Yosuke Omae, Minae Kawashima, Licht Toyo-Oka, Seik-Soon Khor, Hiromi Sawai, Tetsuya Horita, Tatsuya Atsumi, Atsuko Murashima, Daisuke Fujita, Tomio Fujita, Shinji Morimoto, Eriko Morishita, Shinji Katsuragi, Tamao Kitaori, Kinue Katano, Yasuhiko Ozaki, Katsushi Tokunaga
Antiphospholipid syndrome (APS) is the most important treatable cause of recurrent pregnancy loss. The live birth rate is limited to only 70-80% in patients with APS undergoing established anticoagulant therapy. Lupus anticoagulant (LA), but not anticardiolipin antibody (aCL), was found to predict adverse pregnancy outcome. Recent genome-wide association studies (GWAS) of APS focusing on aCL have shown that several molecules may be involved. This is the first GWAS for obstetric APS focusing on LA. A GWAS was performed to compare 115 Japanese patients with obstetric APS, diagnosed according to criteria of the International Congress on APS, and 419 healthy individuals...
September 2017: Journal of Human Genetics
https://www.readbyqxmd.com/read/28401195/live-birth-pregnancy-outcome-after-first-in-vitro-fertilization-treatment-in-a-patient-with-systemic-lupus-erythematosus-and-isolated-high-positive-iga-anti-%C3%AE-2glycoprotein-i-antibodies-a-case-report
#14
Hristina Andreeva, Marit Seip, Stanislava Koycheva
IgA anti-β2glycoprotein I antibodies (IgA-anti-β2GPI) seems to be the most prevalent isotype in patients with Systemic Lupus Erythematosus (SLE) with a significant association to thrombotic events. Both SLE and antiphospholipid syndrome (APS) can be associated with implantation failure, fetal loss and obstetric complications. Recent reports highlight the clinical value of IgA-anti-β2GPI determination in supporting in vitro fertilization (IVF) treatment and IVF pregnancy outcomes. We report a 36-year-old female diagnosed with SLE, endometriosis and unexplained infertility...
January 2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28302338/-laboratory-diagnosis-of-antiphospholipid-syndrome-from-criteria-to-practice
#15
V Joste, M-A Dragon-Durey, L Darnige
The antiphospholipid syndrome is a bioclinical entity defined by thrombosis and/or obstetrical complications in the presence, at least 12 weeks apart, of antiphospholipid antibodies detected by coagulation test (lupus anticoagulant) or immunological assays (anticardiolipin, anti-β2-glycoprotein I antibodies). Biological markers' improvement such as anti-phosphatidylserine/prothrombin and biological score should allow better patients' management and preventive therapeutic for thrombosis and obstetrical complications...
March 14, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28262233/antiphospholipid-syndrome
#16
REVIEW
Ricard Cervera
The antiphospholipid syndrome (APS) is defined by the development of venous and/or arterial thromboses, often multiple, and pregnancy morbidity (mainly, recurrent fetal losses), in the presence of antiphospholipid antibodies (aPL). Some estimates indicate that the incidence of the APS is around 5 new cases per 100,000 persons per year and the prevalence around 40-50 cases per 100,000 persons. The aPL are positive in approximately 13% of patients with stroke, 11% with myocardial infarction, 9.5% of patients with deep vein thrombosis and 6% of patients with pregnancy morbidity...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28238314/-obstetrical-aps-is-there-a-place-for-additional-treatment-to-aspirin-heparin-combination
#17
A Mekinian, G Kayem, J Cohen, L Carbillon, N Abisror, L Josselin-Mahr, M Bornes, O Fain
Obstetrical APS is defined by thrombosis and/or obstetrical morbidity associated with persistent antiphospholipid antibodies. The aspirin and low molecular weighted heparin combination dramatically improved obstetrical outcome in APS patients. Several factors could be associated with obstetrical prognosis, as previous history of thrombosis, associated SLE, the presence of lupus anticoagulant and triple positivity of antiphospholipid antibodies. Obstetrical APS with isolated recurrent miscarriages is mostly associated with isolated anticardiolipids antibodies and have better obstetrical outcome...
January 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28173738/pregnancy-failure-in-patients-with-obstetric-antiphospholipid-syndrome-with-conventional-treatment-the-influence-of-a-triple-positive-antibody-profile
#18
J O Latino, S Udry, F M Aranda, S D A Perés Wingeyer, D S Fernández Romero, G F de Larrañaga
Conventional treatment of obstetric antiphospholipid syndrome fails in approximately 20-30% of pregnant women without any clearly identified risk factor. It is important to identify risk factors that are associated with these treatment failures. This study aimed to assess the impact of risk factors on pregnancy outcomes in women with obstetric antiphospholipid syndrome treated with conventional treatment. We carefully retrospectively selected 106 pregnancies in women with obstetric antiphospholipid syndrome treated with heparin + aspirin...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28164533/possibility-of-coagulation-system-activation-determination-with-tissue-factor-in-pregnancy-complications
#19
Ludek Slavik, Martin Novak, Jana Ulehlova, Martin Prochazka, Jana Prochazkova, Veronika Lattova, Petr Polak, Radovan Pilka
BACKGROUND: In this part of the study, where we determined the causes of preeclampsia and other obstetric complications, we focused on the role of tissue factor (TF) in the activation of these pathophysiological processes. Recent findings attribute a significant part of the activation of coagulation creation of autoantibodies. Once this mechanism is activated, the antibodies induce expression of tissue factor (TF, CD142) on monocytes and vascular endothelial cells. METHODS: We have proposed a monitor activation model of the coagulation system in preeclampsia and other pregnancy complications using TF expression on monocytes by flow cytometry and simultaneous determination the TF-induced thrombin generation in plasma...
October 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28138914/obstetric-and-perinatal-outcome-in-anti-ro-ssa-positive-pregnant-women-a-prospective-cohort-study
#20
Nuria Martínez-Sánchez, Sergio Pérez-Pinto, Ángel Robles-Marhuenda, Francisco Arnalich-Fernández, María Martín Cameán, Edurne Hueso Zalvide, Jose Luis Bartha
Anti-Ro/SS-A is one specific type of antinuclear antibodies. They are in the majority of cases associated with primary Sjögren syndrome (SS) but also in Systemic Lupus Erythematosus (SLE), rheumatoid arthritis (RA), and in healthy people. During pregnancy, they are mainly associated to congenital heart block (CHB) and neonatal lupus (NL). The aim of this study was to compare the rate of maternal and fetal complications between a series of anti-Ro/SS-A positive pregnant women prospectively followed. Forty-two anti-Ro/SSA antibodies positive pregnant women that were referred to our hospital between 2011 and 2015...
April 2017: Immunologic Research
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