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Antiphospholipid and pregnancy

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https://www.readbyqxmd.com/read/28445926/antiphospholipid-syndrome-and-pregnancy-pathogenesis-to-translation
#1
REVIEW
Vikki M Abrahams, Lawrence W Chamley, Jane E Salmon
No abstract text is available yet for this article.
April 26, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28441446/fetal-outcomes-and-associated-factors-of-adverse-outcomes-of-pregnancy-in-southern-chinese-women-with-systemic-lupus-erythematosus
#2
Zhongping Zhan, Ying Yang, Yanfeng Zhan, Dongying Chen, Liuqin Liang, Xiuyan Yang
This study aims to investigate the fetal outcomes and associated factors of adverse pregnancy outcomes (APOs) in pregnant women with systemic lupus erythematosus (SLE). Clinical data from 251 SLE patients with 263 pregnancies from 2001 to 2015 were analyzed retrospectively. APOs occurred in 70.0% of pregnancies, in which pregnancy loss occurred in 28.5%; preterm delivery occurred in 21.3%; intrauterine growth retardation occurred in 12.2%; and fetal distress occurred in 8.0%. Over time, the rate of APOs decreased from 82...
2017: PloS One
https://www.readbyqxmd.com/read/28424481/the-first-genome-wide-association-study-identifying-new-susceptibility-loci-for-obstetric-antiphospholipid-syndrome
#3
Mayumi Sugiura-Ogasawara, Yosuke Omae, Minae Kawashima, Licht Toyo-Oka, Seik-Soon Khor, Hiromi Sawai, Tetsuya Horita, Tatsuya Atsumi, Atsuko Murashima, Daisuke Fujita, Tomio Fujita, Shinji Morimoto, Eriko Morishita, Shinji Katsuragi, Tamao Kitaori, Kinue Katano, Yasuhiko Ozaki, Katsushi Tokunaga
Antiphospholipid syndrome (APS) is the most important treatable cause of recurrent pregnancy loss. The live birth rate is limited to only 70-80% in patients with APS undergoing established anticoagulant therapy. Lupus anticoagulant (LA), but not anticardiolipin antibody (aCL), was found to predict adverse pregnancy outcome. Recent genome-wide association studies (GWAS) of APS focusing on aCL have shown that several molecules may be involved. This is the first GWAS for obstetric APS focusing on LA. A GWAS was performed to compare 115 Japanese patients with obstetric APS, diagnosed according to criteria of the International Congress on APS, and 419 healthy individuals...
April 20, 2017: Journal of Human Genetics
https://www.readbyqxmd.com/read/28401195/live-birth-pregnancy-outcome-after-first-in-vitro-fertilization-treatment-in-a-patient-with-systemic-lupus-erythematosus-and-isolated-high-positive-iga-anti-%C3%AE-2glycoprotein-i-antibodies-a-case-report
#4
Hristina Andreeva, Marit Seip, Stanislava Koycheva
IgA anti-β2glycoprotein I antibodies (IgA-anti-β2GPI) seems to be the most prevalent isotype in patients with Systemic Lupus Erythematosus (SLE) with a significant association to thrombotic events. Both SLE and antiphospholipid syndrome (APS) can be associated with implantation failure, fetal loss and obstetric complications. Recent reports highlight the clinical value of IgA-anti-β2GPI determination in supporting in vitro fertilization (IVF) treatment and IVF pregnancy outcomes. We report a 36-year-old female diagnosed with SLE, endometriosis and unexplained infertility...
January 2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28400421/kidney-outcomes-and-risk-factors-for-nephritis-flare-de-novo-in-a-multiethnic-cohort-of-pregnant-patients-with-lupus
#5
Jill P Buyon, Mimi Y Kim, Marta M Guerra, Sifan Lu, Emily Reeves, Michelle Petri, Carl A Laskin, Michael D Lockshin, Lisa R Sammaritano, D Ware Branch, T Flint Porter, Allen Sawitzke, Joan T Merrill, Mary D Stephenson, Elisabeth Cohn, Jane E Salmon
BACKGROUND AND OBJECTIVES: Kidney disease is a critical concern in counseling patients with lupus considering pregnancy. This study sought to assess the risk of renal flares during pregnancy in women with previous lupus nephritis in partial or complete remission, particularly in those with antidouble-stranded DNA antibodies and low complement levels, and the risk of new-onset nephritis in patients with stable/mildly active SLE. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We assessed active nephritis (renal flares and de novo kidney disease) and associated predictors during pregnancy in patients with lupus with urine protein ≤1000 mg and serum creatinine <1...
April 11, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28398429/antiphospholipid-syndrome-in-a-patient-with-rheumatoid-arthritis
#6
Ryan E O'Leary, Jennifer L Hsiao, Scott D Worswick
Antiphospholipid syndrome (APS) is an autoimmune condition characterized by a thrombotic event and/or pregnancy morbidity in the presence of persistently elevated antiphospholipid (aPL) antibody titers, which are most prevalent in patients with systemic lupus erythematosus but also have been associated with other autoimmune, malignant, and infectious diseases. In contrast to the clear correlation between high aPL antibody titers and thrombotic events in patients with systemic lupus erythematosus, the pathogenic role of these autoantibodies in association with other diseases, such as rheumatoid arthritis (RA), is not as well defined...
March 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28394231/long-term-neurodevelopmental-outcome-of-children-born-to-prospectively-followed-pregnancies-of-women-with-systemic-lupus-erythematosus-and-or-antiphospholipid-syndrome
#7
C Nalli, A Iodice, L Andreoli, J Galli, A Lojacono, M Motta, E Fazzi, A Tincani
Background Systemic lupus erythematosus (SLE) and antiphospholipid antibody syndrome (APS) are autoimmune diseases that affect women of childbearing age. Maternal IgG antiphospholipid antibodies (aPL) can cross the placenta during pregnancy and theoretically reach the fetal brain. Some studies showed an increased number of learning disabilities in these children. Objectives To evaluate the long-term neurodevelopmental outcome of 40 children (median age 7.4 years) born to mothers with SLE and/or APS carrying positive IgG aPL during the third trimester of pregnancy...
April 2017: Lupus
https://www.readbyqxmd.com/read/28393472/reduction-of-annexin-a5-anticoagulant-ratio-identifies-antiphospholipid-antibody-positive-patients-with-adverse-clinical-outcomes
#8
Lucia R Wolgast, Alan A Arslan, Xiao-Xuan Wu, Jessica Niakan, Vittorio Pengo, Jacob H Rand
BACKGROUND: Annexin A5 (A5) is a potent anticoagulant protein that shields anionic phospholipids from availability for coagulation reactions. Previous studies showed that antibodies from patients with antiphospholipid (aPL) syndrome (APS) interfere with A5 crystallization and anticoagulant activity. OBJECTIVE: The purpose of this study was to investigate whether reduction of the Annexin A5 Anticoagulant Ratio (A5R) assay (i.e. "A5 resistance") is associated with adverse clinical events in aPL antibody-positive patients...
April 10, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28390561/contraception-in-patients-with-rheumatic-disease
#9
REVIEW
Lisa R Sammaritano
Contraception represents an important area of reproductive health for patients with rheumatic diseases given the potential pregnancy risks associated with active disease, teratogenic medications, and severe disease-related damage. A high proportion of patients with rheumatic disease do not use effective contraception. Long-acting contraceptives are most effective. Antiphospholipid-negative patients with stable systemic lupus erythematosus may use oral combined contraceptives. Antiphospholipid-positive patients, or patients with rheumatic disease with other risk factors for thrombosis, should avoid estrogen-containing contraceptives...
May 2017: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/28363116/clinical-significance-of-anti-domain-1-%C3%AE-2-glycoprotein-i-antibodies-in-antiphospholipid-syndrome
#10
Teresa Iwaniec, Marcin P Kaczor, Magdalena Celińska-Löwenhoff, Stanisław Polański, Jacek Musiał
BACKGROUND: Antiphospholipid syndrome (APS) is characterized by the presence of circulating antiphospholipid antibodies (aPL) in patients with thrombosis and/or pregnancy morbidity. In APS patients anti-domain 1 β2-glycoprotein I (anti-D1 β2GPI) IgG antibodies correlate strongly with thrombosis and to the lesser extent, with pregnancy complications. The aim of this study was to assess clinical utility of the anti-D1 β2GPI antibodies in the diagnosis and risk stratification of antiphospholipid syndrome...
February 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28360907/aspirin-the-mechanism-of-action-revisited-in-the-context-of-pregnancy-complications
#11
REVIEW
Angela P Cadavid
Aspirin is one of the most frequently used and cheapest drugs in medicine. It belongs to the non-steroidal anti-inflammatory drugs with a wide range of pharmacological activities, including analgesic, antipyretic, and antiplatelet properties. Currently, it is accepted to prescribe a low dose of aspirin to pregnant women who are at high risk of preeclampsia (PE) because it reduces the onset of this complication. Another pregnancy alteration in which a low dose of aspirin is recommended is the obstetric antiphospholipid syndrome (APS)...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28342880/-for-a-targeted-use-of-aspirin
#12
H Madar, S Brun, F Coatleven, A Nithart, C Lecoq, M Gleyze, B Merlot, L Sentilhes
The use of low-dose aspirin in pregnancy should remain a highly targeted indication since its long-term safety has not been established and should be restricted to women at high risk of vascular complications. Indications for which the benefit of aspirin has been shown are women with a history of preeclampsia responsible for a premature birth before 34 weeks, those having at least two history of preeclampsia, those with an antiphospholipid syndrome and those with lupus associated with positive antiphospholipid antibodies or renal failure...
March 22, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28339096/pathogenesis-and-management-of-antiphospholipid-syndrome
#13
REVIEW
Deepa R J Arachchillage, Mike Laffan
Antiphospholipid antibodies are a heterogeneous group of autoantibodies that have clear associations with thrombosis and pregnancy morbidity, and which together constitute the 'antiphospholipid syndrome' (APS). However, the pathophysiology of these complications is not well understood and their heterogeneity suggests that more than one pathogenic process may be involved. Diagnosis remains a combination of laboratory analysis and clinical observation but there have been significant advances in identifying specific pathogenic features, such as domain I-specific anti-β2-glycoprotein-I antibodies...
March 24, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28296762/effect-on-mother-and-child-of-eculizumab-given-before-caesarean-section-in-a-patient-with-severe-antiphospholipid-syndrome-a-case-report
#14
Alice Gustavsen, Lillemor Skattum, Grethe Bergseth, Bjorg Lorentzen, Yngvar Floisand, Vidar Bosnes, Tom Eirik Mollnes, Andreas Barratt-Due
RATIONALE: Antiphospholipid syndrome (APS) in pregnancy may trigger the life-threatening catastrophic antiphospholipid syndrome (CAPS). Complement activation is implicated in the pathogenesis, and inhibition of complement factor C5 is suggested as an additional treatment option. PATIENT CONCERNS, DIAGNOSIS AND INTERVENTIONS: We present a pregnant patient treated with the C5-inhibitor eculizumab due to high risk of developing devastating APS-related complications...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28278524/management-of-thrombotic-antiphospholipid-syndrome
#15
Cecilia Beatrice Chighizola, Maria Gabriella Raimondo, Pier Luigi Meroni
Persistent serum positivity for antiphospholipid antibodies (aPL) is required to diagnose antiphospholipid syndrome (APS), an autoimmune disease characterized by recurrent vascular thrombosis and/or pregnancy morbidity. The current therapeutic management of patients with thrombotic APS aims at preventing recurrences and long-term complications by attenuating the procoagulant state. There is overall consensus to reserve moderate-intensity anticoagulation to aPL-positive patients with a previous venous thrombosis; the therapeutic options for those with a history of arterial event comprise antiplatelet agents and high-intensity anticoagulation...
March 9, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28262233/antiphospholipid-syndrome
#16
Ricard Cervera
The antiphospholipid syndrome (APS) is defined by the development of venous and/or arterial thromboses, often multiple, and pregnancy morbidity (mainly, recurrent fetal losses), in the presence of antiphospholipid antibodies (aPL). Some estimates indicate that the incidence of the APS is around 5 new cases per 100,000 persons per year and the prevalence around 40-50 cases per 100,000 persons. The aPL are positive in approximately 13% of patients with stroke, 11% with myocardial infarction, 9.5% of patients with deep vein thrombosis and 6% of patients with pregnancy morbidity...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28262231/antiphospholid-antibodies-and-the-risk-of-pregnancy-complications
#17
Jean-Christophe Gris, Sylvie Bouvier, Eva Nouvellon, Géraldine Lissalde-Lavigne, Erick Mercier, Jean-Pierre Balducchi, Pierre Marès
Antiphospholipid antibodies (APLAbs) are generally considered as risk factors for foetal death, for premature birth ≤34weeks due to severe pre-eclampsia or severe placental insufficiency and for recurrent consecutive spontaneous abortions <10weeks. Among these three obstetrical morbidities, only the first one is however not regularly questioned. The coexistence of an inflammatory disease and/or of thrombotic manifestations increases the obstetrical risks. Among the three criteria APLAbs, i.e. lupus anticoagulant (LA), anticardiolipin (aCL) Abs, anti-β2 glycoprotein-I (aβ2GP1)Abs, LA seems the more widely associated to clinical risks, the clinical impact of aβ2GP1Abs is progressively defined and the pejorative impact of triple positivity is still discussed...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28238314/-obstetrical-aps-is-there-a-place-for-additional-treatment-to-aspirin-heparin-combination
#18
A Mekinian, G Kayem, J Cohen, L Carbillon, N Abisror, L Josselin-Mahr, M Bornes, O Fain
Obstetrical APS is defined by thrombosis and/or obstetrical morbidity associated with persistent antiphospholipid antibodies. The aspirin and low molecular weighted heparin combination dramatically improved obstetrical outcome in APS patients. Several factors could be associated with obstetrical prognosis, as previous history of thrombosis, associated SLE, the presence of lupus anticoagulant and triple positivity of antiphospholipid antibodies. Obstetrical APS with isolated recurrent miscarriages is mostly associated with isolated anticardiolipids antibodies and have better obstetrical outcome...
January 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28217618/recurrent-first-trimester-abortion-in-a-young-female-rare-presentation-of-takayasu-arteritis
#19
Suruchi Gupta, Puneet Chhabra, Nikhil Gupta, Parul Aggarwal
Takayasu arteritis (TA) is a chronic, progressive, autoimmune, idiopathic, and large-vessel vasculitis that usually affects young adults, especially females. TA primarily affects the aorta and its major branches, the coronary arteries, and the pulmonary arteries. Recurrent pregnancy loss is usually defined as three or more consecutive losses occurring at <20 weeks' gestation of a clinically recognized pregnancy. Common causes of recurrent fetal loss include anatomic, chromosomal, hormonal, infectious, or antiphospholipid antibody syndrome...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28181217/hypercoagulability-and-migraine
#20
Gretchen E Tietjen, Stuart A Collins
BACKGROUND: A growing body of literature suggests that migraineurs, particularly those with aura, have an increased risk for ischemic stroke, but not via enhanced atherosclerosis. The theory that micro-emboli induced ischemia provokes cortical spreading depression (ie, symptomatic aura) in migraineurs but transient ischemic attacks in others highlights a potential role for hypercoagulability as a link between migraine (with aura) and stroke. AIM: Our objective is to summarize the literature evaluating the association of migraine with various acquired or inheritable thrombophilic states, including those related to elevated estrogen levels, endothelial activation and dysfunction, antiphospholipid antibodies (aPL), deficiency of coagulation inhibitors, and presence of certain genetic polymorphisms...
February 9, 2017: Headache
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