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https://www.readbyqxmd.com/read/29627719/interference-of-doacs-in-different-drvvt-assays-for-diagnosis-of-lupus-anticoagulants
#1
T Flieder, M Weiser, Th Eller, M Dittrich, K von Bargen, S Alban, J Kuhn, C Knabbe, I Birschmann
OBJECTIVE: Determination of lupus anticoagulants (LA) is an important, but still challenging test in the diagnosis of antiphospholipid syndrome (APS). This is especially the case in patients using one of the direct oral anticoagulants (DOACs). The aim of our study was to examine the influence of these drugs on DRVVT assays from two companies (in each case: screening test, confirming test and calculated ratio) and on aPTT and lupus-sensitive aPTT. METHODS: We used plasma samples from healthy volunteers spiked with the DOACs dabigatran, rivaroxaban and apixaban (0, 10, 30, 50, 100 ng/mL) for testing...
March 21, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29624847/use-of-direct-oral-anticoagulants-in-antiphospholipid-syndrome
#2
REVIEW
Hannah Cohen, Maria Efthymiou, David Isenberg
The direct oral anticoagulants (DOACs) are therapeutic alternatives to warfarin and other vitamin K antagonists (VKAs), and the standard of care for many indications. VKAs are conventional therapy for the treatment and secondary thromboprophylaxis of thrombotic antiphospholipid syndrome (APS), but are often problematic due to the variable sensitivity of thromboplastins to lupus anticoagulant. Thus, the International Normalised Ratio may not accurately reflect anticoagulation intensity, or be clinically effective...
April 6, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29624078/the-effect-of-3-2-and-3-8-sodium-citrate-on-specialized-coagulation-tests
#3
Franz Ratzinger, Mona Lang, Sabine Belik, Klaus G Schmetterer, Helmuth Haslacher, Thomas Perkmann, Peter Quehenberger
CONTEXT: - Coagulation testing is challenging and depends on preanalytic factors, including the citrate buffer concentration used. OBJECTIVE: - To better estimate preanalytic effects of the citrate buffer concentration in use, the difference between results obtained by samples with 3.2% and 3.8% citrate was evaluated. DESIGN: - In a prospective observational study with 76 volunteers, differences related to the citrate concentration were evaluated...
April 6, 2018: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/29581905/antiphospholipid-antibody-induced-by-nivolumab
#4
Ahmed Aburahma, Nour Aljariri Alhesan, Farah Elounais, Emad Abu Sitta
Nivolumab is a monoclonal antibody against the programmed death protein 1 and is used for patients with advanced melanoma. It is associated with potentially immune-related adverse events, including disorders of the skin, GI tract, and the thyroid; these disorders were successfully treated with prednisone and infliximab. Other immunotherapeutic agents were observed to induce the formation of antiphospholipid antibody (APA) including α -interferon and interleukin-2. We present a case of APA development after the third dose of nivolumab in a 71-year-old male with advanced melanoma...
2018: Case Reports in Hematology
https://www.readbyqxmd.com/read/29576632/maternal-thrombophilia-and-recurrent-miscarriage-is-there-evidence-that-heparin-is-indicated-as-prophylaxis-against-recurrence
#5
Ana-Luisa Stefanski, Christoph Specker, Rebecca Fischer-Betz, Wolfgang Henrich, Ekkehard Schleussner, Thomas Dörner
Background: Recurrent miscarriage, also referred to as recurrent spontaneous abortion (RSA), affects 1 - 5% of couples and has a multifactorial genesis. Acquired and congenital thrombophilia have been discussed as hemostatic risk factors in the pathogenesis of RSA. Method: This review article was based on a selective search of the literature in PubMed. There was a special focus on the current body of evidence studying the association between RSA and antiphospholipid syndrome and hereditary thrombophilia disorders...
March 2018: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/29573340/the-adsorption-of-dabigatran-is-as-efficient-as-addition-of-idarucizumab-to-neutralize-the-drug-in-routine-coagulation-assays
#6
M Jacquemin, J Toelen, L Feyen, J Schoeters, I Van Horenbeeck, I Vanlinthout, M Debasse, T Vanassche, K Peerlinck, P Verhamme
INTRODUCTION: The direct thrombin inhibitor dabigatran interferes with thrombophilia screening and with the diagnosis of hemostasis disorders that develop during treatment with the anticoagulant. In vitro addition of idarucizumab, a humanized antibody fragment that binds dabigatran, to plasma samples containing dabigatran fully neutralizes the drug. This study was carried out to determine whether binding of dabigatran on selected insoluble commercial adsorbent material, DOAC-STOPR , was as efficient as idarucizumab to neutralize the anticoagulant activity of the drug in vitro...
March 24, 2018: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29541945/anticoagulation-management-during-cardiopulmonary-bypass-in-patients-with-antiphospholipid-syndrome
#7
Tatsuya Seki, Yasushige Shingu, Hiroshi Sugiki, Satoru Wakasa, Hiroki Katoh, Tomonori Ooka, Tsuyoshi Tachibana, Suguru Kubota, Yoshiro Matsui
Antiphospholipid syndrome (APS) is a complex autoimmune disease often related to systemic lupus erythematosus. Although adequate anticoagulation is important for APS patients during cardiopulmonary bypass, clotting tests can be potentially misleading due to antiphospholipid antibodies. We performed cardiac surgery safely in two APS patients under anticoagulation monitoring determined using preoperative heparin titration. We performed heparin titration for activated clotting time to determine the appropriate heparin concentration during cardiac surgery...
March 14, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29541874/update-on-antiphospholipid-syndrome-ten-topics-in-2017
#8
REVIEW
Ilaria Cavazzana, Laura Andreoli, Maarteen Limper, Franco Franceschini, Angela Tincani
PURPOSE OF REVIEW: This review focuses on new clinical aspects of antiphospholipid syndrome (APS) in the last 5 years. RECENT FINDINGS: The pathogenesis of APS is related to endothelial activation by mechanisms other than autoantibody-mediated massive coagulation. These include Toll-like receptors, the m-TORC pathway, and neutrophil activation, inducing an uncontrolled inflammatory cascade. Given these new pathogenetic hypotheses, the treatment of APS could be directed towards a fine balance between anticoagulation and immunomodulation...
March 15, 2018: Current Rheumatology Reports
https://www.readbyqxmd.com/read/29538673/recurrent-pregnancy-loss-evaluation-combined-with-24-chromosome-microarray-of-miscarriage-tissue-provides-a-probable-or-definite-cause-of-pregnancy-loss-in-over-90-of-patients
#9
F Popescu, C R Jaslow, W H Kutteh
STUDY QUESTION: Will the addition of 24-chromosome microarray analysis on miscarriage tissue combined with the standard American Society for Reproductive Medicine (ASRM) evaluation for recurrent miscarriage explain most losses? SUMMARY ANSWER: Over 90% of patients with recurrent pregnancy loss (RPL) will have a probable or definitive cause identified when combining genetic testing on miscarriage tissue with the standard ASRM evaluation for recurrent miscarriage...
March 12, 2018: Human Reproduction
https://www.readbyqxmd.com/read/29532986/laboratory-criteria-for-antiphospholipid-syndrome-communication-from-the-ssc-of-the-isth
#10
K M J Devreese, T L Ortel, V Pengo, B de Laat
No abstract text is available yet for this article.
February 14, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29532744/associations-between-maternal-clinical-features-and-fetal-outcomes-in-pregnancies-of-mothers-with-connective-tissue-diseases
#11
Ayako Ohyama, Hiroto Tsuboi, Hisashi Noma, Mayu Terasaki, Masaru Shimizu, Hirofumi Toko, Fumika Honda, Mizuki Yagishita, Hiroyuki Takahashi, Hiromitsu Asashima, Shinya Hagiwara, Yuya Kondo, Isao Matsumoto, Takayuki Sumida
OBJECTIVES: The purpose of this study is to clarify associations between maternal clinical features and adverse pregnancy outcomes (APOs) in mothers with connective tissue diseases (CTDs). METHODS: We retrospectively examined maternal clinical features including backgrounds, autoantibodies, CTD flare-ups, and therapies during pregnancies as well as fetal outcomes in 90 pregnancies (66 mothers) at our hospital from January 2006 to September 2016. RESULTS: Underlying CTDs were SLE (N = 41), MCTD (N = 10), RA (N = 15), SS (N = 10), and others (N = 14)...
March 13, 2018: Modern Rheumatology
https://www.readbyqxmd.com/read/29523280/can-thrombophilia-worsen-maternal-and-perinatal-outcomes-in-cases-of-severe-preeclampsia
#12
Fernanda Spadotto Baptista, Maria Rita de Figueiredo Lemos Bortolotto, Fabiola Roberta Marim Bianchini, Vera Lucia Jornada Krebs, Marcelo Zugaib, Rossana Pulcinelli Vieira Francisco
OBJECTIVE: To evaluate whether thrombophilia worsens maternal and foetal outcomes among patients with severe preeclampsia (PE). METHOD: From October 2009 to October 2014, an observational retrospective cohort study was performed on pregnant women with severe PE diagnosed before 34 weeks of gestation and their newborns hospitalized at the Clinics Hospital, FMUSP. Patients who had no heart disease, nephropathies, pre-gestational diabetes, gestational trophoblastic disease, foetal malformation, or twin pregnancy and who underwent thrombophilia screening during the postnatal period were included...
January 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29521043/clinical-and-immunological-characteristics-of-polish-patients-with-systemic-lupus-erythematosus
#13
Martyna Tomczyk-Socha, Hanna Sikorska-Szaflik, Marek Frankowski, Karolina Andrzejewska, Agnieszka Odziomek, Magdalena Szmyrka
BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with varied clinical manifestations, which creates difficulties and delays in establishing a diagnosis. OBJECTIVES: The aim of this study was to evaluate the prevalence and nature of the clinical symptoms of SLE, both at the onset of the disease and in its further course. An attempt to assess the immunological characteristics of the patients and to analyze autoantibodies variability over time was also made...
January 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29518638/thrombophilia-testing-in-children-what-and-when-should-be-tested
#14
REVIEW
Ulrike Nowak-Göttl, Heleen van Ommen, Gili Kenet
Venous thrombosis (VTE) in children is gaining increased awareness and apart from underlying medical conditions, recently reported systematic reviews on pediatric VTE (70% provoked) have shown significant associations between thrombosis and presence of inherited thrombophilic risk factors (IT), such as protein C-, protein S- and antithrombin deficiency, mutations of factor 5 (F5: rs6025) and factor 2 (F2: rs1799963), even more pronounced when combined IT were involved. Although we have learned more about the pathophysiology of VTE with the increased discovery of IT evidence is still lacking as to whether IT influence the clinical outcome in pediatric VTE...
February 21, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29490924/antiphospholipid-antibodies-and-recurrent-thrombosis-after-a-first-unprovoked-venous-thromboembolism
#15
Clive Kearon, Sameer Parpia, Fredrick A Spencer, Trevor Baglin, Scott M Stevens, Kenneth A Bauer, Steven R Lentz, Craig M Kessler, James D Douketis, Stephan Moll, Scott Kaatz, Sam Schulman, Jean M Connors, Jeffrey S Ginsberg, Luciana Spadafora, Vinai Bhagirath, Patricia C Liaw, Jeffrey I Weitz, Jim A Julian
It is uncertain whether antiphospholipid antibodies (APA) increase the risk of recurrence after a first unprovoked venous thromboembolism (VTE). We tested for anticardiolipin antibodies, anti-β2 glycoprotein I antibodies and lupus anticoagulant on two occasions about six months apart in 307 patients with a first unprovoked VTE who were part of a prospective cohort study. We then determined if APA were associated with recurrent thrombosis in the 290 patients who stopped anticoagulant therapy in response to negative D-dimer results...
February 28, 2018: Blood
https://www.readbyqxmd.com/read/29490410/effect-of-additional-treatments-combined-with-conventional-therapies-in-pregnant-patients-with-high-risk-antiphospholipid-syndrome-a-multicentre-study
#16
Amelia Ruffatti, Marta Tonello, Ariela Hoxha, Savino Sciascia, Maria J Cuadrado, José O Latino, Sebastian Udry, Tatiana Reshetnyak, Nathalie Costedoat-Chalumeau, Nathalie Morel, Luca Marozio, Angela Tincani, Laura Andreoli, Ewa Haladyj, Pier L Meroni, Maria Gerosa, Jaume Alijotas-Reig, Sara Tenti, Karoline Mayer-Pickel, Michal J Simchen, Maria T Bertero, Sara De Carolis, Véronique Ramoni, Arsène Mekinian, Elvira Grandone, Aldo Maina, Fátima Serrano, Vittorio Pengo, Munther A Khamashta
The effect of additional treatments combined with conventional therapy on pregnancy outcomes was examined in high-risk primary antiphospholipid syndrome (PAPS) patients to identify the most effective treatment strategy. The study's inclusion criteria were (1) positivity to lupus anticoagulant alone or associated with anticardiolipin and/or anti-β2 glycoprotein I antibodies; (2) a history of severe maternal-foetal complications (Group I) or a history of one or more pregnancies refractory to conventional therapy leading to unexplained foetal deaths not associated with severe maternal-foetal complications (Group II)...
February 28, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29484705/what-should-be-the-laboratory-approach-against-isolated-prolongation-of-a-activated-partial-thromboplastin-time
#17
Mesude Falay, Mehmet Senes, Dogan Yücel, Turan Turhan, Simten Dagdaş, Melike Pekin, Namik K Nazaroglu, Gülsüm Özet
BACKGROUND: This study is a retrospective evaluation of patients who were subject to mixing study in our laboratory due to prolonged APTT. The preliminary diagnoses, clinical manifestations, and results of additional ordered tests were reviewed. The study aims to investigate whether repeating APTT test with a different assay prior to performing mixed study in patients with prolonged APTT would be a better alternative algorithmic approach in order to save both time and costs. METHODS: We retrospectively evaluated 166 patients (65 females and 101 males) who were subject to mixing study due to isolated prolonged APTT...
February 27, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29471673/identifying-additional-risk-factors-for-thrombosis-and-pregnancy-morbidities-among-antiphospholipid-antibodies-carriers
#18
Yu Zuo, Jennifer Fan, Ravi Sarode, Song Zhang, Una E Makris, David R Karp, Yu-Min Shen
The evaluation of thrombotic and pregnancy risks associated with antiphospholipid antibodies (aPL)in individual patients without antiphospholipid syndrome (APS) clinical manifestation is challenging. Our aim is to identify additional risk factors or potential candidate "second hits" for APS clinical events in a large cohort of ethnically diverse aPL-positive patients. We included 219 consecutive aPL-positive patients who attended clinic at our institution. All patients had at least 1 persistent high titer (≥99 percentiles) aPL...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29462407/transitional-changes-in-the-incidence-of-osteonecrosis-in-systemic-lupus-erythematosus-patients-focus-on-immunosuppressant-agents-and-glucocorticoids
#19
Kento Nawata, Junichi Nakamura, Kei Ikeda, Shunsuke Furuta, Hiroshi Nakajima, Seiji Ohtori, Shigeo Hagiwara, Yasushi Wako, Michiaki Miura, Yuya Kawarai, Masahiko Sugano, Kensuke Yoshino, Sumihisa Orita, Kazuhide Inage, Tsutomu Akazawa
Objective: The purpose of this study was to investigate transitional changes in the incidence of glucocorticoid-associated osteonecrosis in SLE patients, with a focus on immunosuppressive agent and glucocorticoid consumption. Methods: We retrospectively registered 185 SLE patients with 740 joints, who were newly diagnosed and hospitalized for initial high-dose glucocorticoid therapy from 1986 to 2015. Immunosuppressive agent, glucocorticoid dose, age, sex, organ lesion at hospitalization, complement (C3, C4, CH50) and anti-DNA antibody before initial glucocorticoid therapy, the frequency of use of anticoagulant and antilipidemic drugs, and incidence of osteonecrosis were documented...
February 14, 2018: Rheumatology
https://www.readbyqxmd.com/read/29460700/the-lupus-patient-with-positive-rheumatoid-factor
#20
A Fedrigo, T A F G Dos Santos, R Nisihara, T Skare
Background Patients with systemic lupus erythematosus (SLE) may form clusters with clinical manifestations and autoantibodies. Objective The objective of this report is to study whether SLE patients with positive rheumatoid factor (RF) have a special clinical and/or serological profile. Methods A retrospective study of 467 SLE patients seen at a single rheumatology unit was conducted. Epidemiological data (age, gender, age at disease onset, ethnic background and tobacco use), clinical data (malar rash, photosensitivity, oral ulcers, discoid lesions, serositis, glomerulonephritis, convulsions, psychosis, hemolytic anemia, leukopenia, lymphocytopenia, arthritis and hypothyroidism) and serological profile (anti-dsDNA, anti-Ro/SS-A, anti-La/SS-B, anti-RNP, anti-Sm, IgG aCL, IgM aCL, lupus anticoagulant, direct Coombs and RF) were collected...
January 1, 2018: Lupus
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