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Antiphospholipid Syndrome

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https://www.readbyqxmd.com/read/28528615/chronic-tender-ulcers-on-the-calf-and-both-forearms
#1
Michael C Cameron, Mitsuya Katayama, Nishit S Patel, Philip D Shenefelt, Charurut Somboonwit
An elderly woman presented with a 3-month history of nonhealing, tender ulcers involving the right calf and both forearms. She denied any history of similar lesions or trauma. Two trials of oral antibiotics had led to no improvement. Her medical history was significant for rheumatoid arthritis treated with methotrexate, hydroxychloroquine, and prednisone. A review of clinical manifestations was otherwise negative for disease. Physical examination of the patient's right calf revealed two punched-out ulcers with central necrotic black eschars, underlying retiform purpuric pattern, and mild fibrinopurulent drainage (Figure 1)...
2017: Skinmed
https://www.readbyqxmd.com/read/28528521/myeloid-populations-in-systemic-autoimmune-diseases
#2
REVIEW
María Morell, Nieves Varela, Concepción Marañón
Systemic autoimmune diseases (SADs) encompass a wide spectrum of clinical signs as a reflection of their complex physiopathology. A variety of mechanisms related with the innate immune system are in the origin of the loss of self-tolerance in these diseases, and for most of them, the myeloid leukocytes are key actors. Monocytes, macrophages, dendritic cells, and neutrophils are first-line immune effectors located in the interface between innate and adaptive immunity. They are crucial in the organization of the local and systemic responses to damage-associated molecular patterns (DAMPs) and determine the intensity, orientation, and duration of the local immune response through the expression of chemokines, costimulatory or protolerogenic factors...
May 20, 2017: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/28525532/the-effects-of-indirect-and-direct-acting-anticoagulants-on-lupus-anticoagulant-assays-a-large-retrospective-study-at-a-coagulation-reference-laboratory
#3
Jansen N Seheult, Michael P Meyer, Franklin A Bontempo, Irina Chibisov
Objectives: To investigate the effects of indirect- and direct-acting anticoagulants on the interpretation of lupus anticoagulant (LAC) assays. Methods: A retrospective database review was performed to identify all LAC panels from November 2012 to November 2015. The positivity rates for three LAC tests were compared among various anticoagulant medications. Results: This analysis included 7,721 LAC panels. Direct oral anticoagulants, warfarin, and unfractionated heparin (UFH) were associated with higher LAC positivity rates compared with patients not receiving documented anticoagulation (83% for argatroban, 58% for dabigatran, 72% for rivaroxaban, 53% for apixaban, 56% for warfarin, and 36% for UFH vs 29% for no anticoagulation, P < ...
May 19, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28520321/-multifocal-osteonecrosis-revealing-an-antiphospholipid-syndrome-case-report
#4
S Legrève, G Brands
This article illustrates the case of a 30-year-old woman presenting with multifocal osteonecrosis as the first symptom of a primary antiphospholipid syndrome. The association of multifocal osteonecrosis and primary antiphospholipid syndrome without any medical history of vascular thrombosis or pregnancy complications remains rare.
May 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28516871/diagnosis-of-catastrophic-anti-phospholipid-syndrome-in-a-patient-tested-negative-for-conventional-tests
#5
Fabrizio Conti, Roberta Priori, Cristiano Alessandri, Roberta Misasi, Antonella Capozzi, Monica Pendolino, Simona Truglia, Silvia Frisenda, Maurizio Sorice, Guido Valesini
Catastrophic antiphospholipid syndrome (CAPS) is a severe variant of APS, characterised by clinical evidence of multiple organ involvement developing over a very short period of time, histopathological evidence of multiple small vessel occlusions and laboratory confirmation of the presence of aPL (lupus anticoagulant and/or anticardiolipin antibodies and/or anti-Beta2-glcyoprotein I antibodies). Here we report a case of a 39-year-old woman patient who developed a CAPS which was negative to the conventional aPL but positive for aPL in thin layer chromatography immunostaining and vimentin/cardiolipin antibodies by ELISA test...
May 8, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28515823/lupus-negative-libman-sacks-endocarditis-complicated-by-catastrophic-antiphospholipid-syndrome
#6
Ghulam Murtaza, Joy Iskandar, Tara Humphrey, Sujeen Adhikari, Aneesh Kuruvilla
Libman-Sacks endocarditis is characterized by sterile and verrucous lesions that predominantly affect the aortic and mitral valves. In most cases, patients do not have significant valvular dysfunction. However, patients with significant valvular dysfunction may present with serious complications such as cardiac failure, arrhythmias, and thromboembolic events. Recently, association of Libman-Sacks endocarditis with antiphospholipid antibody syndrome (APS) has been made. APS is most commonly defined by venous and arterial thrombosis, recurrent pregnancy loss, and thrombocytopenia...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28508963/hemodiafiltration-for-hepatic-encephalopathy-induced-by-budd-chiari-syndrome-in-a-patient-with-end-stage-kidney-disease
#7
Takuya Wakamatsu, Suguru Yamamoto, Kenya Kamimura, Takeshi Nakatsue, Noriaki Iino, Seitaro Iguchi, Yoshikatsu Kaneko, Shin Goto, Junichiro James Kazama, Ichiei Narita
A 36-year-old woman who was undergoing dialysis for end-stage kidney disease (ESKD) was admitted to our hospital with consciousness disorder. She was diagnosed with Budd-Chiari syndrome due to antiphospholipid syndrome at the age of 28 years. Her kidney function and leg edema gradually deteriorated. After initiation of hemodialysis (HD), transient loss of consciousness due to hepatic encephalopathy during HD treatment occurred frequently. Her kidney replacement therapy was changed to online hemodiafiltration (HDF), which dramatically improved her hepatic coma...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28508528/competing-risks-model-in-screening-for-preeclampsia-in-twin-pregnancies-by-maternal-characteristics-and-medical-history
#8
Carla Francisco, David Wright, Zsófia Benkő, Argyro Syngelaki, Kypros H Nicolaides
OBJECTIVE: A survival-time regression model for the gestational age at delivery with preeclampsia (PE) in singleton pregnancies using maternal demographic characteristics and medical history was previously reported. The objective of this paper is to extend this model for dichorionic (DC) and monochorionic (MC) twin pregnancies. METHODS: The study population included 1,789 DC and 430 MC twin pregnancies and 93,297 singleton pregnancies. A survival-time model for the gestational age at delivery with PE was developed from variables of maternal characteristics and history...
May 15, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28503285/oral-contraceptive-related-transverse-sinus-thrombosis-as-an-initial-manifestation-of-antiphospholipid-syndrome-in-the-absence-of-systemic-lupus-erythematosus
#9
Payam Saadat, Reza Mohseni-Ahangar
BACKGROUND: Cerebral venous sinus thrombosis is a rare and potentially life-threatening neurologic manifestation of antiphospholipid syndrome. Oral contraceptive pills (OCP) may increase the risk of vascular events, even in people without family history of venous thrombosis. CASE PRESENTATION: A 31-year-old woman with four weeks of constant headache and history of taking OCP for one year has been selected for this study. The results of magnetic resonance imaging (MRI) of brain and venography confirmed a diagnosis of cerebral venous sinus thrombosis...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28502943/the-development-of-cerebral-venous-thrombosis-after-tadalafil-ingestion-in-a-patient-with-antiphospholipid-syndrome
#10
Kenji Numata, Kouhei Shimoda, Yasushi Shibata, Ayako Shioya, Yasuharu Tokuda
We report a case of cerebral venous thrombosis related to the ingestion of tadalafil. A 45-year-old man presented with posterior headache and was diagnosed with tension headache. Five days later, he was transported to our hospital via ambulance due to a tonic-clonic seizure. Head MRI showed cerebral venous thrombosis (CVT). He confessed to having recently taken a large doses of tadalafil. His anti-cardiolipin antibody and anti-caldiolipin-β2-glycoprotein-I complex antibody levels were elevated. Our case suggests the possibility that tadalafil is related to both cardiovascular complications and CVT in patients with hypercoagulability...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28502938/successful-treatment-of-catastrophic-antiphospholipid-antibody-syndrome-associated-with-malt-lymphoma-by-autologous-hematopoietic-stem-cell-transplantation
#11
Satoko Oka, Kazuo Ono, Masaharu Nohgawa
A 37-year-old woman with extranodal marginal-zone lymphoma was admitted with a fever, hemiplegia, and severe dyspnea after chemotherapy. Catastrophic antiphospholipid antibody syndrome (CAPS) was suspected based on the histopathological confirmation of small-pulmonary vessel occlusion, evidence of the involvement of three organs, and elevated lupus anticoagulant assay results in a short time span. The patient responded to the initial treatment. One month later, the CAPS and lymphoma relapsed, and the patient underwent autologous hematopoietic stem cell transplantation...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28488841/catastrophic-antiphospholipid-syndrome-an-update
#12
Gerard Espinosa, Ignasi Rodriguez-Pinto, Ricard Cervera
Catastrophic antiphospholipid syndrome (CAPS) is a rare variant that accounts for 1% of patients with APS. Despite its low frequency, the mortality-related is very high ranging from 50% of patients in the first series to 37% in the most recent data. The current knowledge of this potential devastating entity comes from the International Registry of patients with CAPS, named CAPS Registry. Small vessel thrombosis, laboratory features of microangiopathic haemolytic anemia, and development of multisystem involvement in a very short period of time are the main characteristics of this syndrome...
May 8, 2017: Panminerva Medica
https://www.readbyqxmd.com/read/28483615/severe-mesenteric-ischemia-in-a-pregnant-woman-with-antiphospholipid-syndrome
#13
Andrea Padricelli, Anna Maria Giribono, Doriana Ferrara, Flavia Spalla, Umberto Bracale, Luca Del Guercio, Giuseppe Servillo, Carlo Ruotolo, Umberto Marcello Bracale
The antiphospholipid syndrome (APS), either primary or secondary form, is considered an autoimmune disease with presence of at least one clinical and one laboratory abnormalities as defined by The Sydney criteria. Clinical criteria include vascular thrombosis of venous, artery, small vessel in any organ and recurrent pregnancy pathologies. Mesenteric ischemia is a rare and threatening manifestation of APS. We herein report a case of 34-years old pregnant woman referred to our Emergency Room with thoracic and abdominal acute pain...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479827/simultaneous-occurrence-of-deep-vein-thrombosis-and-carotid-artery-thrombosis-in-antiphospholipid-antibody-syndrome
#14
Rohan R Mahale, Anish Mehta, Srinivasa Rangasetty
No abstract text is available yet for this article.
April 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28479751/uterine-cd56-dim-and-cd16-cells-in-refractory-antiphospholipid-antibody-related-pregnancy-loss-and-chromosomally-intact-abortuses-a-case-control-study
#15
Mostafa F Gomaa, Abdeiiatif G Elkhouly, Mohammad M Farghly, Laila A Farid, Nahla M Awad
AIM: To evaluate the role of uterine natural killer (uNK) CD56(dim) and CD16(+) cells in patients with refractory antiphospholipid, antibody-mediated, recurrent, pregnancy loss. SETTINGS AND DESIGN: A case-control study was conducted between 2012 and 2015 at a university hospital. PATIENTS AND METHODS: A group of 118 women with a history of antiphospholipid antibody syndrome experiencing fetal loss in spite of low dose aspirin (LDA) and low molecular weight heparin (LMWH) treatment in the current pregnancy were included in this study...
January 2017: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/28479750/serum-protein-profile-in-women-with-pregnancy-morbidity-associated-with-antiphospholipid-syndrome
#16
Angela M Alvarez, Stefan Neubeck, Sergio Parra, Udo R Markert, Angela P Cadavid
CONTEXT: Antiphospholipid antibodies (aPL) are related with a high risk of pregnancy morbidity (PM) and also of vascular thrombosis. On the basis of recent studies, we expect that in women with PM associated with antiphospholipid syndrome (APS), further factors may be deregulated and involved in pathophysiology of the disease. Such factors may have the potential to become novel biomarkers for APS and its stages. SETTINGS AND DESIGN: Descriptive study from a recurrent pregnancy loss program...
January 2017: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/28476065/extracellular-vesicles-in-the-antiphospholipid-syndrome
#17
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/28475479/risk-of-hemorrhagic-transformation-after-ischemic-stroke-in-patients-with-antiphospholipid-antibody-syndrome
#18
Tapan Mehta, Mohammed Hussain, Khushboo Sheth, Yuchuan Ding, Louise D McCullough
BACKGROUND AND PURPOSE: Several rheumatologic conditions including systemic lupus erythematosus, antiphospholipid antibody (APS) syndrome, rheumatoid arthritis, and scleroderma are known risk factors for stroke. The risk of hemorrhagic transformation after an acute ischemic stroke (AIS) in these patients is not known. METHODS: We queried the Nationwide Inpatient Sample (NIS) data between 2010 and 2012 with ICD 9 diagnostic codes for AIS. The primary outcome was the development of hemorrhagic transformation...
June 2017: Neurological Research
https://www.readbyqxmd.com/read/28474094/perioperative-management-of-patients-with-antiphospholipid-syndrome-a-single-center-experience
#19
Yemil Atisha-Fregoso, Eric Espejo-Poox, Eduardo Carrillo-Maravilla, Alma Lilia Pulido-Ramírez, Diego Lugo Baruqui, Gabriela Hernández-Molina, Antonio R Cabral
The objective was to describe the management and risk factors for complications of antiphospholipid syndrome (APS) patients who underwent a surgical procedure in a single center. We reviewed medical records of all patients with primary or secondary APS who underwent an elective surgery during a 6-year period. Demographical data, management of anticoagulation and complications were recorded. We identified 43 patients, mean age 37.9 ± 8.9 years, who underwent a total of 48 elective surgeries. All patients had history of at least one thrombotic event and were under vitamin K antagonists...
May 4, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28473677/antithrombotic-effects-of-hydroxychloroquine-in-a-pregnant-patient-with-antiphospholipid-syndrome-and-recurrent-venous-thromboembolism
#20
S P Gan, S G Ong
A pregnant woman with antiphospholipid syndrome presented with repeated venous thromboembolism (VTE) in the first and second trimesters of pregnancy despite receiving combination therapy with low-molecular-weight heparin and aspirin. The addition of hydroxychloroquine prevented further VTE recurrence, thus demonstrating its potential antithrombotic effects.
April 2017: Medical Journal of Malaysia
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