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https://www.readbyqxmd.com/read/28803708/anti-phospholipid-syndrome-current-opinion-on-mechanisms-involved-laboratory-characterization-and-diagnostic-aspects
#1
REVIEW
Jean Amiral, Marie Peyrafitte, Claire Dunois, Anne Marie Vissac, Jerard Seghatchian
Anti-phospholipid syndrome is a complex and severe clinical situation, associated with symptoms such as recurrent thrombosis, arterial or venous, at any site, pregnancy loss, and other related syndromes. These clinical burdens, are highly variable from patient to patient, and are associated with biological abnormalities, such as the presence of the Lupus Anticoagulant or phospholipid dependent antibodies, confirmed on two occasions at least 12 weeks apart. From the diagnosis standpoint, both, functional (clotting) or immunological assays, are difficult to standardize and to optimize, due to the absence of reference material, or a characteristic clinical group, and international reference preparations...
July 15, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28800668/-epidemiology-risk-factors-and-risk-stratification-of-venous-thromboembolism-in-pregnancy-and-the-puerperium
#2
Panagiotis Tsikouras, Georg-Friedrich von Tempelhoff, Werner Rath
Venous thromboembolism (VTE) remains a leading cause of direct maternal deaths in the developed countries. The incidence of VTE has increased significantly during the past two decades. The absolute risk of VTE is estimated 0.6-2.2 per 1000 deliveries. Compared with age-matched non-pregnant women, the daily risk of VTE is increased 7- to 10-fold for antepartum VTE, but it is 15- to 35-fold for postpartum VTE. The incidence of pulmonary embolism (PE) during the first 6 weeks postpartum is nearly 15-fold higher compared to the incidence in pregnancy, and remains significantly increased up to 12 weeks postpartum...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28798699/schizophrenia-or-atypical-lupus-erythematosus-with-predominant-psychiatric-manifestations-over-25%C3%A2-years-case-analysis-and-review
#3
Axel Mack, Christiane Pfeiffer, E Marion Schneider, Karl Bechter
We observed a case over 25 years of relapsing-remitting schizophrenic spectrum disorder, varying regarding the main symptomatology between more depressive or more schizoaffective or rather typical schizophrenic syndrome. Diseased phases were repeatedly accompanied by minor skin lesions, which were initially classified as mixed tissue disorder. Psychotic phases were waxing-waning over years. During one later relapse, skin involvement was severe, classified to likely represent an allergic reaction to psychopharmaca; this generalized exanthema remitted rapidly with cortisone treatment and azathioprine...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28769114/diagnosing-antiphospholipid-syndrome-extra-criteria-manifestations-and-technical-advances
#4
REVIEW
Savino Sciascia, Mary-Carmen Amigo, Dario Roccatello, Munther Khamashta
First described in the early 1980s, antiphospholipid syndrome (APS) is a unique form of acquired autoimmune thrombophilia in which patients present with clinical features of recurrent thrombosis and pregnancy morbidity and persistently test positive for the presence of antiphospholipid antibodies (aPL). At least one clinical (vascular thrombosis or pregnancy morbidity) and one lab-based (positive test result for lupus anticoagulant, anticardiolipin antibodies and/or anti-β2-glycoprotein 1 antibodies) criterion have to be met for a patient to be classified as having APS...
August 3, 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/28728509/do-adverse-pregnancy-outcomes-contribute-to-accelerated-cardiovascular-events-seen-in-young-women-with-systemic-lupus-erythematosus
#5
M C Soh, C Nelson-Piercy, M Westgren, L McCowan, D Pasupathy
Cardiovascular events (CVEs) are prevalent in patients with systemic lupus erythematosus (SLE), and it is the young women who are disproportionately at risk. The risk factors for accelerated cardiovascular disease remain unclear, with multiple studies producing conflicting results. In this paper, we aim to address both traditional and SLE-specific risk factors postulated to drive the accelerated vascular disease in this cohort. We also discuss the more recent hypothesis that adverse pregnancy outcomes in the form of maternal-placental syndrome and resultant preterm delivery could potentially contribute to the CVEs seen in young women with SLE who have fewer traditional cardiovascular risk factors...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28727732/incidence-of-thromboembolic-events-in-asymptomatic-carriers-of-iga-anti-%C3%A3-2-glycoprotein-i-antibodies
#6
Carlos Tortosa, Oscar Cabrera-Marante, Manuel Serrano, José A Martínez-Flores, Dolores Pérez, David Lora, Luis Morillas, Estela Paz-Artal, José M Morales, Daniel Pleguezuelo, Antonio Serrano
BACKGROUND: The antiphospholipid syndrome (APS) is defined by simultaneous presence of vascular clinical events and antiphospholipid antibodies (aPL). The aPL considered as diagnostics are lupus anticoagulant and antibodies anticardiolipin (aCL) and anti-ß2 glycoprotein-I (aB2GP1). During recent years, IgA aB2GP1 antibodies have been associated with thrombotic events both in patients positive, and mainly negative for other aPL, however its value as a pro-thrombotic risk-factor in asymptomatic patients has not been well defined...
2017: PloS One
https://www.readbyqxmd.com/read/28711073/lupus-nephritis-and-pregnancy-concerns-and-management
#7
Liz Lightstone, Michelle A Hladunewich
Pregnancy associated with lupus, especially lupus nephritis, is often fraught with concern for both the mother and fetus. Thus, it is paramount that care begins preconception so that proper planning in terms of optimizing the medical regimen, discontinuation of fetotoxic agents, and treatment of active disease can occur. It is well known that active nephritis at the time of conception is associated with poor outcomes. Even with quiescent disease, recent data indicate that being lupus anticoagulant-positive, nonwhite or Hispanic, and using antihypertensive medications were all predictors of worse pregnancy outcomes...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28705036/pregnancy-outcomes-among-women-with-systemic-lupus-erythematosus-a-retrospective-cohort-study-from-thailand
#8
S Phansenee, R Sekararithi, P Jatavan, T Tongsong
Objective The objective of this paper is to compare adverse pregnancy outcomes between normal pregnancies and pregnancies with systemic lupus erythematosus (SLE), particularly focusing on uncomplicated SLE with remission. Methods A retrospective cohort study was conducted by accessing the Maternal-Fetal Medicine (MFM) Unit database and the full medical records of the women. The records of singleton pregnancies with SLE and no underlying disease were assigned as the study group and their medical records were reviewed...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28699378/reasons-for-cesarean-and-medically-indicated-deliveries-in-pregnancies-in-women-with-systemic-lupus-erythematosus
#9
A M Eudy, M Jayasundara, T Haroun, L Neil, A H James, M E B Clowse
Objective To determine reasons for cesarean and medically indicated deliveries in a registry of pregnant women with SLE compared to RA. Methods Pregnant women with SLE or RA were prospectively followed, and pregnancy outcomes were collected, including whether labor was spontaneous or medically indicated and delivery was vaginal or cesarean. Preterm birth was defined as a birth <37 weeks gestation. Differences in reasons for cesarean delivery and indication of delivery between term and preterm births were determined by Fisher's exact test...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28696177/are-prematurity-and-environmental-factors-determinants-for-developing-childhood-onset-systemic-lupus-erythematosus
#10
Paola G Conde, Luis C Farhat, Alfésio L F Braga, Adriana E M Sallum, Sylvia C L Farhat, Clovis A Silva
OBJECTIVE: The objective of this study is to evaluate the influence of exposure to air pollutants and inhalable environmental elements during pregnancy and after birth until childhood-onset systemic lupus erythematosus(cSLE) diagnosis. METHODS: This case-control study comprised 30 cSLE patients and 86 healthy controls living in the Sao Paulo metropolitan area. A structured and reliable questionnaire (kappa index for test-retest was 0.78) assessed demographic data, gestational and perinatal-related-factors, and exposure to inhalable elements during pregnancy and after birth (occupational exposure to inhalable particles and/or volatile vapor, and/or tobacco, as well as, the presence of industrial activities or gas stations near the home/work/daycare/school)...
July 11, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28690949/role-of-sex-hormone-levels-and-psychological-stress-in-the-pathogenesis-of-autoimmune-diseases
#11
REVIEW
Salman Assad, Hamza H Khan, Haider Ghazanfar, Zarak H Khan, Salman Mansoor, Muhammad A Rahman, Ghulam H Khan, Bilal Zafar, Usman Tariq, Shuja A Malik
The aim of this review article is to assess the connection between psychological stress and sex hormones and their effect on the development of autoimmune diseases. Psychological stress describes what people feel when they are under mental, physical, or emotional pressure. We searched for online articles using MEDLINE®, Embase, Cochrane Library and Google Scholar. Our research yielded a total of 165 articles out of which 30 articles were considered for further perusal. The articles were reviewed from February 2016 to February 2017...
June 5, 2017: Curēus
https://www.readbyqxmd.com/read/28678065/pregnancy-and-reproductive-aspects-of-systemic-lupus-erythematosus
#12
Laura Andreoli, Francesca Crisafulli, Angela Tincani
PURPOSE OF REVIEW: To discuss pregnancy and reproductive aspects in women with systemic lupus erythematosus (SLE) with particular focus on preconception counselling, maternal and foetal outcomes, safety and beneficial effects of drugs during pregnancy as well as contraception methods, assisted reproduction techniques and strategies for thromboembolism prophylaxis in patients with positive antiphospholipid antibodies. RECENT FINDINGS: Evidence-based recommendations for the management of family planning and women's health issues in SLE and/or APS have been developed by a multidisciplinary panel of experts...
September 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28667788/altered-%C3%AE-2-glycoprotein-i-expression-on-microparticles-in-the-presence-of-antiphospholipid-antibodies
#13
Fariborz Mobarrez, Iva Gunnarsson, Elisabet Svenungsson
BACKGROUND: Antiphospholipid antibodies (aPL) together with thrombosis and/or pregnancy morbidities characterize the antiphospholipid syndrome. β2-glycoprotein-I (β2 GPI), the most important antigen for aPL, is a scavenger molecule that specifically binds to phosphatidylserine (PS), expressed on microparticles (MPs). OBJECTIVES: We evaluated β2 GPI-expressing MPs in patients with systemic lupus erythematosus (SLE) stratified for aPL status, and healthy controls...
July 1, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28658887/a-screening-study-on-dermatoses-in-pregnancy
#14
K Kannambal, G K Tharini
INTRODUCTION: Pregnancy produces many cutaneous changes, some of which are specifically related to pregnancy (dermatoses of pregnancy), some are modifiable by pregnancy and others that are common are named physiologic. These physiologic skin changes, usually do not impair the health of the mother or the fetus but some of them can be cosmetically significant and of importance to the dermatologist. AIM: The present study was undertaken to find out the prevalence of the physiological and pathological skin changes in pregnancy, and to correlate the prevalence of the major cutaneous changes and diseases in relation to different trimesters of pregnancy and with gravidity...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28647939/non-criteria-or-seronegative-obstetric-antiphospholipid-syndrome
#15
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/28647487/does-pregnancy-have-any-impact-on-long-term-damage-accrual-and-on-the-outcome-of-lupus-nephritis
#16
Davide Gianfreda, Silvana Quaglini, Giulia Frontini, Francesca Raffiotta, Piergiorgio Messa, Gabriella Moroni
No data are available about the impact of pregnancy on the long-term outcome of lupus nephritis. Thirty-two women with lupus nephritis with a 10-year follow-up after their first pregnancy ("women who gave birth") and 64 matched controls with the same follow-up and who never had pregnancies ("controls") were compared for the occurrence of SLE flares, chronic kidney disease (CKD), and SLICC/ACR Damage Index (SDI) in the post pregnancy period. The same evaluations were done before and after pregnancy in women who gave birth...
June 21, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28626188/discoid-lupus-erythematosus-complicated-with-pregnancy-induced-hemophagocytic-syndrome
#17
Hideto Takada, Naoki Kimura, Yoko Yoshihashi-Nakazato, Kimito Kawahata, Hitoshi Kohsaka
A 35-year-old woman with discoid lupus erythematosus (DLE) was admitted at 11 weeks' gestation with a persistent fever. Laboratory studies revealed pancytopenia, elevated liver enzymes, and hyperferritinemia. Bone marrow aspiration confirmed the diagnosis of hemophagocytic syndrome (HPS). She had no findings of infection or active systemic lupus erythematosus. The administration of high-dose corticosteroids resolved the clinical and laboratory findings. She delivered a healthy baby at 35 weeks' gestation. This case suggests that DLE can be a predisposing factor for pregnancy-induced HPS...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28603203/neonatal-lupus-erythematosus
#18
Naoto Yokogawa, Naofumi Sumitomo, Masaru Miura, Kazuhiko Shibuya, Hiroshi Nagai, Mikako Goto, Atsuko Murashima
  Neonatal lupus (NL), a passively-acquired autoimmune disease associated with maternal anti-SSA antibody, presents both cardiac manifestations such as cardiac NL and non-cardiac manifestations including rashes, cytopenia, and hepatic abnormalities. Cardiac NL, occurring in 1-2% of anti-SS-A antibody-positive mothers, is a life-threatening complication with a mortality rate of 20% and a pacemaker implantation rate of 70%. In contrast, cutaneous NL, which is more common than cardiac NL, usually resolves in six months...
2017: Nihon Rinshō Men'eki Gakkai Kaishi, Japanese Journal of Clinical Immunology
https://www.readbyqxmd.com/read/28598777/no-histologic-evidence-of-foetal-cardiotoxicity-following-exposure-to-maternal-hydroxychloroquine
#19
Deborah Friedman, Leif Lovig, Marc Halushka, Robert M Clancy, Peter M Izmirly, Jill P Buyon
It is currently recommended that hydroxychloroquine (HCQ) be maintained during pregnancy in patients with systemic lupus erythematosus. Recent data suggest that this Toll-like receptor inhibitor may also reduce the recurrence rate of anti-SSA/Ro associated congenital heart block (CHB). This case report describes a unique situation in which a CHB-afflicted, HCQ-exposed pregnancy was electively terminated. The heart did not reveal any characteristic features of cardiotoxicity, providing further evidence supporting the safety of foetal exposure to HCQ...
June 6, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28595349/prenatal-exposure-to-antimalarials-decreases-the-risk-of-cardiac-but-not-non-cardiac-neonatal-lupus-a-single-centre-cohort-study
#20
Julie Barsalou, Edgar Jaeggi, Carl A Laskin, Patrick Brown, Simon Y Tian, Robert M Hamilton, Earl D Silverman
Objective: . Recent studies have suggested that prenatal exposure to HCQ reduces the risk of cardiac neonatal lupus. The aim of this study is to assess if maternal intake of antimalarials (AMs) throughout pregnancy lowered the risk of cardiac and non-cardiac neonatal lupus. Methods: . Consecutive children seen between 1 January 1984 to 1 October 2013 born to women with a CTD and positive anti-Ro and/or anti-La antibodies were eligible for this single-centre retrospective cohort study...
June 8, 2017: Rheumatology
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