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https://www.readbyqxmd.com/read/29471673/identifying-additional-risk-factors-for-thrombosis-and-pregnancy-morbidities-among-antiphospholipid-antibodies-carriers
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/29451664/update-on-antiphospholipid-antibody-syndrome
#4
Michelle Remião Ugolini Lopes, Adriana Danowski, Andreas Funke, Jozelia Rêgo, Roger Levy, Danieli Castro Oliveira de Andrade
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by antiphospholipid antibodies (aPL) associated with thrombosis and/or pregnancy morbidity. Most APS events are directly related to thrombotic events, which may affect small, medium or large vessels. Other clinical features like thrombocytopenia, nephropathy, cardiac valve disease, cognitive dysfunction and skin ulcers (called non-criteria manifestations) add significant morbidity to this syndrome and represent clinical situations that are challenging...
November 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/29448257/nonbacterial-thrombotic-endocarditis-presenting-with-leg-pain-and-a-left-atrial-mass-lesion
#5
Ahmed A Abouarab, Adham Elmously, Jeremy R Leonard, Mohammed J Arisha, Mario Gaudino, Naveent Narula, Arash Salemi
Systemic lupus erythematosus (SLE) is a major cause of nonbacterial thrombotic endocarditis (NBTE) associated with intracardiac sterile vegetations. It is rare for vegetations to present as an atrial tumor. This report describes a 48-year-old female with SLE and antiphospholipid syndrome complicated by recurrent thrombosis on anticoagulation. A large left atrial mass lesion was detected on echocardiography during a work-up for leg burning. Infective endocarditis could not be confirmed, and hence left atrial mass lesion was the most likely diagnosis...
February 15, 2018: Cardiology
https://www.readbyqxmd.com/read/29439640/an-evaluation-of-hemostatic-abnormalities-in-patients-with-hemophilia-according-to-the-activated-partial-thromboplastin-time-waveform
#6
Haruna Katayama, Takeshi Matsumoto, Hideo Wada, Naoki Fujimoto, Junki Toyoda, Yasunori Abe, Kohshi Ohishi, Yoshiki Yamashita, Makoto Ikejiri, Koji Habe, Naoyuki Katayama
The usefulness of the waveform of activated partial thromboplastin time (APTT) in various diseases has been evaluated in recent years. The APTT waveform was examined in patients with hemophilia and patients positive for lupus anticoagulant (LA). The correlation with the FVIII activity was highest for the height of acceleration peak. The peak time of acceleration, velocity, and ½ fibrin formation, and the width of acceleration and velocity were significantly long and the height of acceleration was significantly low in patients with hemophilia...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29417312/lessons-learned-from-splenic-infarcts-with-fever-of-unknown-origin-fuo-culture-negative-endocarditis-cne-or-malignancy
#7
REVIEW
Burke A Cunha, Bertamaria Dieguez, Alena Varantsova
Culture negative endocarditis (CNE) is a common concern in patients with fever, heart murmur, cardiac vegetation, and negative blood cultures. The diagnosis of CNE is not based only on negative blood cultures and a cardiac vegetation. The clinical definition of CNE is based on negative blood cultures plus the findings of culture positive infective endocarditis (IE), e.g., fever, cardiac vegetation, splenomegaly, peripheral manifestations. Because embolic splenic infarcts may occur with culture positive IE, some may assume that splenic infarcts are a sign of CNE...
February 7, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29407622/simple-method-for-removing-doacs-from-plasma-samples
#8
T Exner, N Michalopoulos, J Pearce, R Xavier, M Ahuja
AIM: To evaluate a simple method using an adsorbent product (DOAC Stop) for extracting direct oral anti-coagulants (DOACs) from plasmas. METHOD: DOAC Stop was tested on normal and a range of abnormal plasmas initially using activated partial thromboplastin time (APTT) tests and a more DOAC-sensitive Russells viper venom-based clotting test (DOAC Test). Further tests for prothrombin time/International Normalized Ratio (PT/INR), lupus anticoagulants, activated protein C (APC) resistance, antithrombin, plasminogen, protein C and S were carried out on various patient samples...
January 30, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29395258/extra-criteria-manifestations-of-antiphospholipid-syndrome-risk-assessment-and-management
#9
Massimo Radin, Michelle Remião Ugolini-Lopes, Savino Sciascia, Danieli Andrade
OBJECTIVES: Extra-criteria manifestations of antiphospholipid syndrome (APS) might impact on prognosis and morbidity of the disease. In this study, we aimed to evaluate a population of patients with primary APS (PAPS) whether the extra-criteria manifestations were more frequently found in subjects with higher adjusted Global APS Score (aGAPSS) values when compared to patients with thrombotic and/or obstetric APS ("criteria" manifestations) only. METHODS: Clinical records were analyzed to retrieve extra-criteria manifestation of APS, cardiovascular risk factors and antiphospholipid antibodies profile...
January 5, 2018: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29385876/antiphospholipid-syndrome-the-best-prophet-of-the-future
#10
Olga Amengual, Tatsuya Atsumi
The antiphospholipid syndrome (APS) is an autoimmune disorder characterized by the occurrence of venous and arterial thromboses, often multiple, and obstetric-related adverse events in the presence of antiphospholipid antibodies (aPL). APS, first described in 1983, as thrombosis, abortion and cerebral disease, is nowadays recognised as a systemic disease with a wide constellation of clinical manifestations related to acute and chronic vascular lesions. The presence of aPL is the serological hallmark of APS representing a heterogeneous population of autoantibodies with many antigenic specificities directed to phospholipid-binding proteins, either alone or in combination with phospholipids...
February 1, 2018: Modern Rheumatology
https://www.readbyqxmd.com/read/29373903/hemostatic-abnormalities-in-multiple-myeloma-patients
#11
Aarti Gogia, Meera Sikka, Satender Sharma, Usha Rusia
Background: Multiple myeloma (MM) is a neoplastic plasma cell disorder characterized by clonal proliferation of plasma cells in the bone marrow. Diverse hemostatic abnormalities have been reported in patients with myeloma which predispose to bleeding and also thrombosis. Methods: Complete blood count, biochemical parameters and parameters of hemostasis i.e. platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), factor VIII assay results, plasma fibrinogen, D-dimer and lupus anticoagulant, were assessed in 29 MM patients and 30 age matched controls...
January 27, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/29356700/the-effects-of-transport-temperature-and-time-on-routine-and-specialized-coagulation-assays
#12
Yeowon A Kim, Kent B Lewandrowski, Fils-Amie Lucien, Elizabeth M Van Cott
: Coagulation laboratories have largely stopped transporting whole blood specimens on ice, due to adverse effects on factor VIII, von Willebrand factor, and the prothrombin time. However, it is unknown whether ice should be required or avoided for other coagulation assays. Furthermore, the amount of time that specimens remain stable during transportation at room temperature (RT) is also largely unknown for many coagulation tests. Therefore, this study investigated specimen stability on ice and RT for a comprehensive panel of coagulation tests...
March 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29321641/antiphospholipid-syndrome
#13
REVIEW
Karen Schreiber, Savino Sciascia, Philip G de Groot, Katrien Devreese, Soren Jacobsen, Guillermo Ruiz-Irastroza, Jane E Salmon, Yehuda Shoenfeld, Ora Shovman, Beverley J Hunt
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by the presence of antiphospholipid antibodies, such as lupus anticoagulant, anticardiolipin antibodies and anti-β2-glycoprotein 1 antibodies. APS can present with a variety of clinical phenotypes, including thrombosis in the veins, arteries and microvasculature as well as obstetrical complications. The pathophysiological hallmark is thrombosis, but other factors such as complement activation might be important. Prevention of thrombotic manifestations associated with APS includes lifestyle changes and, in individuals at high risk, low-dose aspirin...
January 11, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29320975/systemic-lupus-erythematosus-with-inflammatory-bowel-disease-ulcerative-colitis-case-report
#14
H Elsayed Mansour, S Gamal Arafa, W Abdelfatah Shehata
A 30-year-old female presented to the rheumatology outpatient clinic of the Internal Medicine Department, Ain Shams University Hospital, Cairo, Egypt, complaining of a large right leg ulcer consistent with pyoderma gangrenosum. There was history of recurrent attacks of bleeding per rectum of one-year duration. During hospitalization she noticed blurring of vision in the left eye with diffuse blackish discoloration of the feet and toes, consistent with small-vessel vasculitis. Colonoscopy with biopsy and histopathology confirmed the diagnosis of inflammatory bowel disease-ulcerative colitis (IBD-UC)...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29320972/rituximab-use-in-pediatric-lupus-anticoagulant-hypoprothrombinemia-syndrome-report-of-three-cases-and-review-of-the-literature
#15
K Cetin Gedik, S Siddique, C L Aguiar
Lupus anticoagulant hypoprothrombinemia syndrome (LA-HPS) is a rare condition that may predispose both to thrombosis and bleeding due to positive lupus anticoagulant (LA) and factor II (FII) deficiency. It can be seen in association with infections or systemic lupus erythematosus (SLE) and may require glucocorticoids (GCs) and/or immunosuppressive medications. Pediatric LA-HPS cases in the literature and three cases that received only rituximab (RTX) for LA-HPS (in addition to GCs) at two institutions between January 2010 and June 2017 were analyzed descriptively...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29316357/cerebrovascular-events-in-systemic-lupus-erythematosus
#16
John G Hanly, Qiuju Li, Li Su, Murray B Urowitz, Caroline Gordon, Sang-Cheol Bae, Juanita Romero-Diaz, Jorge Sanchez-Guerrero, Sasha Bernatsky, Ann E Clarke, Daniel J Wallace, David A Isenberg, Anisur Rahman, Joan T Merrill, Paul Fortin, Dafna D Gladman, Ian N Bruce, Michelle Petri, Ellen M Ginzler, M A Dooley, Kristjan Steinsson, Rosalind Ramsey-Goldman, Asad A Zoma, Susan Manzi, Ola Nived, Andreas Jonsen, Munther A Khamashta, Graciela S Alarcón, Winn Chatham, Ronald F van Vollenhoven, Cynthia Aranow, Meggan Mackay, Guillermo Ruiz-Irastorza, Manuel Ramos-Casals, S Sam Lim, Murat Inanc, Kenneth C Kalunian, Soren Jacobsen, Christine A Peschken, Diane L Kamen, Anca Askanase, Chris Theriault, Vernon Farewell
OBJECTIVE: To determine the frequency, associations and outcomes of cerebrovascular events (CerVEs) in a multi-ethnic/racial, prospective, SLE disease inception cohort. METHODS: Patients were assessed annually for 19 neuropsychiatric (NP) events including 5 types of CerVEs: (i) Stroke; (ii) Transient ischemia; (iii) Chronic multifocal ischemia; (iv) Subarachnoid/intracranial hemorrhage; (v) Sinus thrombosis. Global disease activity (SLEDAI-2K), SLICC/ACR damage index (SDI) and SF-36 scores were collected...
January 5, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29308775/a-case-of-immune-thrombocytopenic-purpura-with-prolonged-aptt-time-a-clotter-hidden-in-a-bleeder
#17
M H Lee, P J Khoo, L T Gew, C F Ng
We report the case of a 23-year-old woman who presented with prolonged menstruation and multiple bruises on the limbs and trunk. Investigations revealed severe thrombocytopenia and deranged coagulation profile with markedly prolonged activated partial thromboplastin time (aPTT). Lupus anticoagulant, anti-cardiolipin antibody and anti-beta-2-glycoprotein 1 antibody were positive. She was diagnosed with Immune Thrombocytopenic Purpura (ITP) with positive antiphospholipid antibody serology and given a course of intravenous methylprednisolone and tapering doses of oral prednisolone...
December 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/29301604/bilateral-choroidal-occlusion-in-antiphospholipid-syndrome-associated-with-systemic-lupus-erythematosus
#18
Yang Zhang, Shun-Hua Zhang, Ai-Ling Bian, You-Xin Chen
This article reports a rare case of bilateral choroidal occlusion that occurred in a 24-year-old woman with antiphospholipid syndrome (APS) associated with systemic lupus erythematosus (SLE). This young lady concurred with aorta ventralis thrombosis and bilateral iliac artery occlusion when presented, and experienced a rapid deterioration of vision. She also has a history of recurrent miscarriage. Corticosteroid, immunosuppression and anticoagulation therapy were administered. Patients with APS associated with SLE are at risk for thrombotic phenomena, which may affect the ocular vessels of all sizes, including choroidal vessel...
December 30, 2017: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/29301476/the-cutaneous-manifestations-are-significantly-related-to-cerebrovascular-in-a-serbian-cohort-of-patients-with-hughes-syndrome
#19
L Stojanovich, A Djokovic, N Stanisavljevic, M Zdravkovic
Objectives To investigate a possible relationship between cerebrovascular, such as stroke and transient ischaemic attack, and various cutaneous manifestations (livedo reticularis, skin ulcerations, pseudovasculitis lesions, superficial cutaneous necrosis and digital gangrene) in antiphospholipid syndrome (APS). This report is based on a Serbian cohort of APS patients. Methods A total of 508 antiphospholipid syndrome APS patients were assessed: 360 with primary (PAPS) and 148 with APS associated with SLE (SAPS)...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29284338/catastrophic-antiphospholipid-syndrome-and-pregnancy-clinical-report
#20
J Khizroeva, V Bitsadze, A Makatsariya
We have observed the development of a catastrophic antiphospholipid syndrome (CAPS) in a pregnant woman hospitalized at 28 weeks of gestation with a severe preeclampsia. On the same day, an eclampsia attack developed, and an emergency surgical delivery was performed. On the third day, multiorgan failure developed. Examination showed a persistent circulation of lupus anticoagulant, high level of antibodies to cardiolipin, b2-glycoprotein I, and prothrombin. The usual diagnosis of the severe preeclampsia masked a catastrophic antiphospholipid syndrome, exacerbated by the coincident presence of several types of antiphospholipid antibodies...
December 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
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