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Antiphospholipid in obstetric patient

S Muhammad Shazwan, M Muhammad Aliff, A A Asral Wirda, A R Hayati, M Maizatul Azma, A R Nur Syahrina, A H Nazefah, S Jameela, M M Nur Fariha
INTRODUCTION: Antiphospholipid antibodies (aPL) are autoantibodies that attack phospholipid through anti-beta 2-glycoprotein 1. The actions of aPL are associated with events leading to thrombosis and morbidity in pregnancy. Antiphospholipid syndrome (APS) is diagnosed when a patient is persistently positive for aPL and also has recognised clinical manifestations such as recurrent pregnancy losses, arterial or venous thrombosis and in a catastrophic case, can result in death. Unfortunately, the pathogenesis of APS is still not well established...
December 2016: Malaysian Journal of Pathology
Shulan Zhang, Ziyan Wu, Jing Li, Xiaoting Wen, Liubing Li, Wen Zhang, Jiuliang Zhao, Fengchun Zhang, Yongzhe Li
A hallmark feature of antiphospholipid syndrome (APS) is the presence of antiphospholipid antibodies (aPLs). Few studies have addressed the clinical relevance of anti-annexin A5 antibodies (aANXA5) in Chinese patients with APS. In this study, we evaluated the clinical performance of aANXA5 in the diagnosis of APS. Sera from 313 subjects were tested, including 170 samples from patients with APS, 104 samples from patients with non-APS diseases as disease controls (DC), and 39 healthy controls (HC). Serum IgG and IgM aANXA5 were determined by ELISA...
December 21, 2016: Clinical Rheumatology
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
Frank Bienaimé, Christophe Legendre, Fabiola Terzi, Guillaume Canaud
The antiphospholipid syndrome is a common autoimmune disease caused by pathogenic antiphospholipid antibodies, leading to recurrent thrombosis and/or obstetrical complications. Importantly for nephrologists, antiphospholipid antibodies are associated with various renal manifestations including large renal vessel thrombosis, renal artery stenosis, and a constellation of intrarenal lesions that has been termed antiphospholipid nephropathy. This last condition associates various degrees of acute thrombotic microangiopathy, proliferative and fibrotic lesions of the intrarenal vessels, and ischemic modifications of the renal parenchyma...
January 2017: Kidney International
Eleftheria Lefkou, Apostolos Mamopoulos, Themistoklis Dagklis, Christos Vosnakis, David Rousso, Guillermina Girardi
BACKGROUND: Administration of conventional antithrombotic treatment (low-dose aspirin plus low-molecular weight heparin [LDA+LMWH]) for obstetric antiphospholipid syndrome (APS) does not prevent life-threatening placenta insufficiency-associated complications such as preeclampsia (PE) and intrauterine growth restriction (IUGR) in 20% of patients. Statins have been linked to improved pregnancy outcomes in mouse models of PE and APS, possibly due to their protective effects on endothelium...
August 1, 2016: Journal of Clinical Investigation
Anush Martirosyan, Martin Petrek, Amit Kishore, Gayane Manukyan
Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by thrombosis and recurrent fetal loss, with the persistent presence of antiphospholipid antibodies (aPLs). aPLs exert their pathogenic effect via the overproduction of tissue factor and activation of complement and several cell types, including endothelial cells, platelets and notably monocytes. As a result, a hypercoagulable state develops leading to APS-associated obstetric complications and fetal loss. Despite being far from optimal, treatment of APS usually includes heparin and low dose aspirin...
August 2016: Experimental and Therapeutic Medicine
C M Yelnik, G Urbanski, E Drumez, V Sobanski, H Maillard, A Lanteri, S Morell-Dubois, C Caron, S Dubucquoi, D Launay, A Duhamel, E Hachulla, P Y Hatron, M Lambert
INTRODUCTION: The long-term risk of first thrombosis and benefit of prophylaxis in antiphospholipid antibody (aPL) carriers without history of thrombosis or obstetrical morbidity is poorly known. This study aimed to evaluate the long-term rate and risk factors associated with a first thrombosis in those patients. PATIENTS AND METHODS: After a prior study ended in December 2005 and was already published, we extended the follow-up period of our cohort of aPL carriers...
July 17, 2016: Lupus
Arsène Mekinian, Marie-Charlotte Bourrienne, Lionel Carbillon, Amélie Benbara, Abisror Noémie, Sylvie Chollet-Martin, Ahmed Tigaizin, Francois Montestruc, Olivier Fain, Pascale Nicaise-Roland
OBJECTIVES: To describe the prevalence of non-conventional APL in patients with obstetrical APS without conventional APL and the impact of treatment on pregnancy outcome. METHODS: Patients with clinical obstetrical criteria were tested for anti-phosphatidylethanolamine (aPE) IgG/M, anti-prothrombin/phosphatidylserine (anti-PS/PT) IgG/M, and anti-annexin V IgG. Pregnancy losses rates were compared between APS, non-conventional APS, and non-APL and in untreated pregnancies to treated ones for each group...
October 2016: Seminars in Arthritis and Rheumatism
M Khamashta, M Taraborelli, S Sciascia, A Tincani
Antiphospholipid syndrome (APS) is an autoimmune condition characterized by the occurrence of thrombosis (arterial and/or venous), often multiple, and/or pregnancy morbidity. Thrombosis is one of the major disease mechanisms, mainly caused by activating endothelial cells, monocytes, and platelets. At present, the management of APS patients with a history of thrombosis is based on long-term antithrombotic therapy, due to the high rate of recurrent thrombosis (29% per year without treatment). Obstetrical APS includes heterogeneous pregnancy complications whose pathogenesis has been increasingly elucidated in the past years...
February 2016: Best Practice & Research. Clinical Rheumatology
M Galli, G Finazzi, T Barbui
The Antiphospholipid Syndrome (APS) is defined by the association between antiphospholipid antibodies, i.e. anticardiolipin (aCL) and/or lupus anticoagulant (LA) antibodies, and one or more of the following clinical manifestations: arterial and venous thrombosis, recurrent abortions and thrombocytopenia (1). Among them, deep venous thromboses, pulmonary embolism and thrombosis of the cerebral arteries are the most frequent events, occurring in approximately 1/3 of the patients. Thrombosis of the placental vessels (2) is considered the cause of the obstetrical complications (recurrent spontaneous abortions, fetal deaths or fetal growth retardation) suffered by approximately 10% of the women with antiphospholipid antibodies (1), whereas a variable degree of thrombocytopenia is reported by about 20-25% of the patients (3)...
1996: Hematology (Amsterdam, Netherlands)
Jaume Alijotas-Reig, Raquel Ferrer-Oliveras, Enrique Esteve-Valverde, Amelia Ruffatti, Angela Tincani, Elmina Lefkou, Maria Tiziana Bertero, Gerard Espinosa, Emmanuel Coloma, Sara de Carolis, Patrizia Rovere-Querini, Valentina Canti, Elisa Picardo, Micaela Fredi, Arsene Mekinian
AIM: To analyse the prevalence and effects of inherited thrombophilic disorders (ITD) on maternal-foetal outcomes in cases of antiphospholipid antibody related to obstetric complications. METHODS: Women with obstetric complaints who tested positive for aPL and with inherited thrombophilia were prospectively and retrospectively included. RESULTS: ITD data were available in 208 of 338: 147 had obstetric antiphospholipid syndrome (OAPS) and 61 aPL-related obstetric morbidity (OMAPS)...
August 2016: American Journal of Reproductive Immunology: AJRI
Mirjana Bećarević, Svetlana Ignjatović
The latest classification criteria for the diagnosis of the antiphospholipid syndrome (APS, an autoimmune disease characterized by thromboses, miscarriages and presence of antiphospholipid antibodies (Abs)) emphasized that thrombotic manifestations of APS should be without any signs of an inflammatory process. However, atherosclerosis (a chronic inflammatory response to the accumulation of lipoproteins in the walls of arteries) and APS are characterized by some similar features. We evaluated whether proinflammatory proteins were associated with the features of the primary APS (PAPS)...
October 2016: Clinical Rheumatology
Philipp Scholz, Markus Auler, Bent Brachvogel, Thomas Benzing, Peter Mallman, Thomas Streichert, Andreas R Klatt
Anti-phospholipid syndrome (APS) is one of the main causes for recurrent miscarriages. The diagnosis of APS is based on the occurrence of clinical symptoms such as thrombotic events or obstetric complications as well as the detection of antiphospholipid antibodies directed against β2-glycoprotein I and cardiolipin, or a positive lupus anticoagulant assay. However, there is a subpopulation of patients with clinical symptoms of APS, but the lack of serological markers (seronegative APS). In addition, a large proportion of patients with unexplained recurrent miscarriages exist...
2016: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
Amelia Ruffatti, Ariela Hoxha, Maria Favaro, Marta Tonello, Anna Colpo, Umberto Cucchini, Alessandra Banzato, Vittorio Pengo
Most investigators currently advocate prophylactic-dose heparin plus low-dose aspirin as the preferred treatment of otherwise healthy women with obstetric antiphospholipid syndrome, whilst women with a history of vascular thrombosis alone or associated with pregnancy morbidity are usually treated with therapeutic heparin doses in association with low-dose aspirin in an attempt to prevent both thrombosis and pregnancy morbidity. However, the protocols outlined above fail in about 20 % of pregnant women with antiphospholipid syndrome...
June 25, 2016: Clinical Reviews in Allergy & Immunology
Dulce María Albertina Camarena Cabrera, Claudia Rodriguez-Jaimes, Sandra Acevedo-Gallegos, Juan Manuel Gallardo-Gaona, Berenice Velazquez-Torres, José Antonio Ramírez-Calvo
Antiphospholipid antibody syndrome is a non-inflammatory autoimmune disease characterized by recurrent thrombotic events and/or obstetric complications associated with the presence of circulating antiphospholipid antibodies (anticardiolipin antibodies, anti-β2 glycoprotein-i antibodies, and/or lupus anticoagulant. Antiphospholipid antibodies are a heterogeneous group of autoantibodies associated with recurrent miscarriage, stillbirth, fetal growth restriction and premature birth. The diversity of the features of the proposed placental antiphospholipid antibodies fingerprint suggests that several disease processes may occur in the placentae of women with antiphospholipid antibody syndrome in the form of immune responses: inflammatory events, complement activation, angiogenic imbalance and, less commonly, thrombosis and infarction...
June 9, 2016: Reumatología Clinica
Charis Pericleous, Isabel Ferreira, Orietta Borghi, Francesca Pregnolato, Thomas McDonnell, Acely Garza-Garcia, Paul Driscoll, Silvia Pierangeli, David Isenberg, Yiannis Ioannou, Ian Giles, Pier Luigi Meroni, Anisur Rahman
INTRODUCTION: Currently available clinical assays to detect antiphospholipid antibodies (aPL) test for IgG and IgM antibodies to cardiolipin (aCL) and β2-glycoprotein I (aβ2GPI). It has been suggested that testing for IgA aPL and for antibodies to Domain I (DI), which carries the key antigenic epitopes of β2GPI, could add value to these current tests. We performed an observational, multicenter cohort study to evaluate the utility of IgG, IgM and IgA assays to each of CL, β2GPI and DI in APS...
2016: PloS One
Dirk Roggenbuck, Maria Orietta Borghi, Valentina Somma, Thomas Büttner, Peter Schierack, Katja Hanack, Claudia Grossi, Caterina Bodio, Paolo Macor, Philipp von Landenberg, Francesco Boccellato, Michael Mahler, Pier Luigi Meroni
BACKGROUND: Antiphospholipid antibodies (aPL) can be detected in asymptomatic carriers and infectious patients. The aim was to investigate whether a novel line immunoassay (LIA) differentiates between antiphospholipid syndrome (APS) and asymptomatic aPL+ carriers or patients with infectious diseases (infectious diseases controls (IDC)). METHODS: Sixty-one patients with APS (56 primary, 22/56 with obstetric events only, and 5 secondary), 146 controls including 24 aPL+ asymptomatic carriers and 73 IDC were tested on a novel hydrophobic solid phase coated with cardiolipin (CL), phosphatic acid, phosphatidylcholine, phosphatidylethanolamine, phosphatidylglycerol, phosphatidylinositol, phosphatidylserine, beta2-glycoprotein I (β2GPI), prothrombin, and annexin V...
May 21, 2016: Arthritis Research & Therapy
Maria Laura Bertolaccini, Gregorio Contento, Ross Lennen, Giovanni Sanna, Philip J Blower, Michelle T Ma, Kavitha Sunassee, Guillermina Girardi
Placental ischemic disease and adverse pregnancy outcomes are frequently observed in patients with antiphospholipid syndrome (APS). Despite the administration of conventional antithrombotic treatment a significant number of women continue to experience adverse pregnancy outcomes, with uncertain prevention and management. Efforts to develop effective pharmacological strategies for refractory obstetric APS cases will be of significant clinical benefit for both mothers and fetuses. Although the antimalarial drug, hydroxychloroquine (HCQ) is increasingly used to treat pregnant women with APS, little is known about its efficacy and mechanism of action of HCQ...
May 6, 2016: Journal of Autoimmunity
G Guettrot-Imbert, N Morel, V Le Guern, G Plu-Bureau, C Frances, N Costedoat-Chalumeau
A causal link has long been described between estrogen and systemic lupus erythematosus activity. Contraceptive and pregnancy management is now common for lupus patients, but pregnancy continues to be associated with higher maternal and fetal mortality/morbidity in systemic lupus erythematosus patients than among the general population. Potential complications include lupus flares, obstetric complications (fetal loss, in utero growth retardation, premature birth) and neonatal lupus syndrome. Association with antiphospholipid antibodies or antiphospholipid syndrome increases the risk of obstetric complications...
October 2016: Annales de Dermatologie et de Vénéréologie
Ahlam Al Marzooqi, Alessia Leone, Jamal Al Saleh, Munther Khamashta
Antiphospholipid syndrome (APS) is a prothrombotic disease characterized by thrombosis and pregnancy morbidity in the presence of antiphospholipid antibodies (apL). Management of thrombosis is based on long-term oral anticoagulation and patients with arterial events should be treated aggressively. Primary thrombo-prophylaxis is recommended in patients with systemic lupus erythromatosus (SLE) and obstetric APS. Obstetric APS care is based on high-risk management and treatment with aspirin and heparin. Possible future therapies include statins, hydroxychloroquine, rituximab, and new anticoagulant drugs...
September 2016: Expert Review of Clinical Immunology
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