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Antiphospholipid and pregnancy

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https://www.readbyqxmd.com/read/29772490/effects-of-multiple-inherited-and-acquired-thrombophilia-on-outcomes-of-in-vitro-fertilization
#1
Marcello Di Nisio, Adalisa Ponzano, Gianmario Tiboni, Maria Domenica Guglielmi, Anne Wilhelmina Saskia Rutjes, Ettore Porreca
INTRODUCTION: The effects of multiple inherited and acquired thrombophilic defects on the outcome of in-vitro fertilization (IVF) remain unexplored. The aim of this study was to evaluate the association between multiple thrombophilia and clinical outcomes in a large prospective cohort of women undergoing IVF. MATERIALS AND METHODS: Consecutive women scheduled for IVF were eligible. The primary study outcome was live birth. Secondary outcomes included spontaneous abortion, clinical pregnancy, and symptomatic venous thromboembolism...
May 9, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29771194/preconception-antiphospholipid-antibodies-and-risk-of-subsequent-early-pregnancy-loss
#2
K J Gibbins, S L Mumford, L A Sjaarda, D W Branch, N J Perkins, A Ye, E F Schisterman, R M Silver
Objectives To prospectively estimate the association of preconception antiphospholipid antibodies (aPL) with subsequent pregnancy loss using a cohort design. aPL have been associated with recurrent early pregnancy loss (EPL) prior to 10 weeks in previous case-control studies. Prospective ascertainment of pregnancy loss is challenging, as most women do not seek care prior to EPL. Methods Secondary analysis of the Effects of Aspirin in Gestation and Reproduction trial of preconception low-dose aspirin. Preconception anticardiolipin (aCL) and anti-β2-glycoprotein-I (a-β2-I) were assessed in 1208 women with one or two prior pregnancy losses and no more than two prior live births...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29737455/current-and-future-use-of-chloroquine-and-hydroxychloroquine-in-infectious-immune-neoplastic-and-neurological-diseases-a-mini-review
#3
REVIEW
Domenico Plantone, Tatiana Koudriavtseva
The process of finding new therapeutic indications for currently used drugs, defined as 'repurposing', is receiving growing attention. Chloroquine and hydroxychloroquine, with an original indication to prevent or cure malaria, have been successfully used to treat several infectious (HIV, Q fever, Whipple's disease, fungal infections), rheumatological (systemic lupus erythematosus, antiphospholipid antibody syndrome, rheumatoid arthritis, Sjögren's syndrome), and other immunological diseases. Indeed, they have anti-inflammatory, immunomodulating, anti-infective, antithrombotic, and metabolic effects...
May 8, 2018: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29709100/a-comparison-of-effectiveness-among-frequent-treatments-of-recurrent-spontaneous-abortion-a-bayesian-network-meta-analysis
#4
Sha Lv, Jing Yu, Xiaoxiao Xu
OBJECTIVE: A comprehensive network meta-analysis was designed to clarify contradictions and offer valuable clinical guidance in the treatment of recurrent spontaneous abortion (RSA). METHOD: The included clinical trials were selected from the relevant medical journal databases and screened. Treatments were ranked by the surface under the cumulative ranking curve. Heat plots were constructed to analyze the inconsistency between direct data and network results, and adjusted funnel plots were constructed to assess publication bias...
April 30, 2018: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/29701436/-abnormal-movements-and-internal-medicine-pathologies
#5
Joseph Ghika
Hyperkinesias can be revelaed by an internal medicine pathology. An acute chorea can be found in association with non ketotic hypergycemia, lupus, antiphospholipid syndrome, endocrinopathies, pregnancy or oral contraceptive initiation, or psychostimulant medication. Acute dystonic syndromes are found in association with the initiation of an old generation neuroleptic, metoclopramide, oral contraceptive and pregnancy. It should be differentiated from hyper- or hypo-calcémie tetany. Tremors are found in association with many drugs and hormones...
April 25, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29701415/antiphospholipid-syndrome-and-acute-postpartum-limb-ischemia
#6
Inês Antunes, Carlos Pereira, Rui Machado, Duarte Rego, Vitor Ferreira, João Gonçalves, Gabriela Teixeira, Carlos Veiga, Daniel Mendes, Rui Almeida
INTRODUCTION: The diagnosis of Antiphospholipid syndrome (APS) implies the identification of antiphospoholipid antibodies and arterial/venous thrombosis or pregnancy loss. During pregnancy, there is an increased risk of thrombotic complications. METHODS: Present a case of acute lower limb ischemia in a patient with APS during postpartum period Materials/ Methods: review of a clinical case and available literature Results: Patient diagnosed with APS (triple antibody positive and antecedent of 3 previous abortions) underwent cesarean at 29 weeks of gestation...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29692672/effectiveness-of-high-dose-i-v-immunoglobulin-therapy-for-pregnant-women-with-aspirin-heparin-resistant-secondary-antiphospholipid-syndrome
#7
Yoko Maesawa, Masashi Deguchi, Kenji Tanimura, Mayumi Morizane, Yasuhiko Ebina, Hideto Yamada
Purpose: This study aimed to assess the efficacy of high-dose i.v. immunoglobulin (HIVIg) therapy in pregnant women with antiphospholipid syndrome (APS) secondary to systemic lupus erythematosus with a history of pregnancy failure, despite receiving low-dose aspirin plus unfractionated heparin therapy, of which condition being designated as "aspirin-heparin-resistant APS" (AHRAPS). Methods: The HIVIg therapy (20 g/d, 5 days) was performed for the pregnancies of five women with AHRAPS...
April 2018: Reproductive Medicine and Biology
https://www.readbyqxmd.com/read/29689494/angiogenic-factors-in-pregnancies-of-women-with-antiphospholipid-syndrome-and-systemic-lupus-erythematosus
#8
Karoline Mayer-Pickel, Christina Stern, Katharina Eberhard, Uwe Lang, Barbara Obermayer-Pietsch, Mila Cervar-Zivkovic
OBJECTIVES: An imbalance of angiogenic placental factors such as endoglin, soluble fms-like tyrosine kinase 1(sFlt-1) and placental growth factor (PlGF) has been implicated in the pathophysiology of preeclampsia. This study aimed to evaluate serum levels of sFlt-1, PlGF and endoglin in women with primary and secondary antiphospholipid Syndrome (APS) and systemic lupus erythematosus (SLE) longitudinally through pregnancy. MATERIAL AND METHODS: Serum levels of sFlt-1, PlGF and endoglin were measured prospectively at 4-week intervals (from gestational weeks 12-36) in 17 women with primary APS (PAPS), 18 women with secondary APS (SAPS), and 23 women with SLE...
April 18, 2018: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/29684342/the-relation-between-protein-z-polymorphism-and-the-risk-of-thrombosis-in-egyptian-patients-with-antiphospholipid-syndrome
#9
Yomna K Eissa, Hend N Ellithy, Sherif M Yousry, Zakaria Ismail
BACKGROUND: The genetic background plays an important role in thrombosis and pregnancy morbidities. Low levels of protein Z is associated with increased risk of thrombosis. The G79A polymorphism in the protein Z gene may be a genetic risk factor for thrombosis. AIM OF THE STUDY: To investigate the prevalence and clinical significance of the protein Z-79 G/A gene polymorphism in Egyptian patients with antiphospholipid syndrome (APS). METHODS: We genotyped 60 APS patients and 41 controls, for protein Z-79 G/A gene polymorphism using the PCR-restriction fragment length...
April 17, 2018: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/29676461/antiphospholipid-syndrome-characteristics-and-adverse-pregnancy-outcomes-after-20-weeks-of-pregnancy
#10
Rinat Gabbay-Benziv, Hadas Zafrir-Danieli, Dorit Blickstein, Anat Shmueli, Lina Salman, Eran Hadar
OBJECTIVE: To assess outcomes after 20 weeks of pregnancy according to autoantibody profile and clinical presentation of maternal antiphospholipid syndrome (APS). METHODS: The present retrospective cohort analysis included women diagnosed with APS at a tertiary medical center in Israel between January 1, 2012, and December 31, 2016. Anticardiolipin antibodies, anti-β2-glycoprotein antibodies, and lupus anticoagulant were assessed. Participants were stratified by type of APS (obstetric vs thrombotic), antibody profile, and antibody titer (low vs high)...
April 20, 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29669399/the-impact-of-systemic-lupus-erythematosus-on-the-clinical-phenotype-of-antiphospholipid-antibody-positive-patients-results-from-antiphospholipid-syndrome-alliance-for-clinical-trials-and-international-networking-aps-action-clinical-database-and-repository
#11
Ozan Unlu, Doruk Erkan, Medha Barbhaiya, Danieli Andrade, Iana Nascimento, Renata Rosa, Alessandra Banzato, Vittorio Pengo, Amaia Ugarte, Maria Gerosa, Lanlan Ji, Maria Efthymiou, D Ware Branch, Guilherme Raires de Jesus, Angela Tincani, H Michael Belmont, Paul R Fortin, Michelle Petri, Esther Rodriguez, Guillermo J Pons-Estel, Jason S Knight, Tatsuya Atsumi, Rohan Willis, Stephane Zuily, Maria G Tektonidou
OBJECTIVE: Although systemic lupus erythematosus (SLE) is the most common autoimmune disease associated with antiphospholipid antibodies (aPL), limited data exist on the impact of SLE on the clinical phenotype of aPL-positive patients. The primary objective was to compare the clinical, laboratory, and treatment characteristics of aPL-positive patients with or without SLE. METHODS: A secure web-based data capture system stores patient demographics, and aPL-related clinical and laboratory characteristics...
April 18, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29665758/the-efficacy-of-adjunct-tacrolimus-treatment-in-pregnancy-outcomes-in-patients-with-systemic-lupus-erythematosus
#12
K Ichinose, S Sato, Y Kitajima, Y Horai, K Fujikawa, M Umeda, S Fukui, A Nishino, T Koga, S Y Kawashiri, N Iwamoto, M Tamai, H Nakamura, T Origuchi, I Yasuhi, H Masuzaki, A Kawakami
Systemic lupus erythematosus (SLE) involves multiple organ systems and primarily affects women during their reproductive years. Pregnancy in a woman with SLE may lead to higher rates of disease flares. Little is known regarding which medications are safe to maintain remission and/or treat flares throughout such pregnancies. Here we retrospectively analyzed the efficacy of tacrolimus (TAC) in the pregnancy outcomes of SLE patients. We studied the 54 deliveries of 40 SLE patients over an eight-year period from 2008 to 2016...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29620217/effect-and-mechanism-of-the-a%C3%AE-2%C3%A2-gp-i-rh%C3%AE-2%C3%A2-gp-i-complex-on-jeg%C3%A2-3-cell-proliferation-migration-and-invasion
#13
Xiumin Lu, Lei Ren, Wenjing Zhang, Yanhong Liu
Antiphospholipid antibody (aPL)‑mediated antiphospholipid syndrome (APS) is an autoimmune disease. Upon binding to aPL, the primary antigen of aPL, β2‑glycoprotein I (β2‑GP I), induces abnormal immune function, which further activates downstream signaling pathways in the cell and eventually leads to APS. The present study aimed to determine whether β2‑GP I antigen and anti‑β2‑glycoprotein I antibody (aβ2‑GP I), which belong to the aPL class of antibodies, may affect human chorionic epithelium cell (JEG‑3) proliferation, migration and invasion...
March 29, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29595273/-life-threatening-manifestations-of-lupus-and-antiphospholipid-syndrome-in-internal-medicine
#14
Pavel Horák, Martina Skácelová, Jiří Vymětal, Markéta Schubertová
The clinical picture of systemic lupus and antiphospholipid syndrome is remarkably varied and disease manifestations are commonly very heterogeneous. Relatively often both diseases are associated with severe, acute and life threatening manifestations, which places demands on the knowledge of differential diagnostics and experience of the physicians. This article deals with the serious and mostly acute impairment of cardiovascular, respiratory, renal, gastrointestinal, hematopoietic or nervous systems, briefly discusses the acute pregnancy complication and summarizes the basic therapeutic option...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29593987/luteal-phase-support-for-documented-failure-of-placental-steroidogenesis-a-case-report
#15
Bryan Kratz, Amer Rasheed, John P Holden
Objective: To report a case of a habitual aborter that had a pregnancy reach near term and successfully delivered a viable female infant. Design: Report of a unique case of a G10P1 that was successfully able to maintain a pregnancy by maintaining serum levels of estradiol and progesterone at or above 200 pg/dL and 25 ng/dL respectively. This case provides a benchmark for exogenous support of estradiol and progesterone throughout pregnancy. Setting: A private advanced reproductive center...
April 2017: Case Reports in Women's Health
https://www.readbyqxmd.com/read/29576632/maternal-thrombophilia-and-recurrent-miscarriage-is-there-evidence-that-heparin-is-indicated-as-prophylaxis-against-recurrence
#16
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/29541874/update-on-antiphospholipid-syndrome-ten-topics-in-2017
#17
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
#18
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/29523283/the-role-of-angiogenic-biomarkers-and-uterine-artery-doppler-in-pregnant-women-with-systemic-lupus-erythematosus-or-antiphospholipid-syndrome
#19
M E Rodríguez-Almaraz, I Herraiz, P I Gómez-Arriaga, P Vallejo, E Gonzalo-Gil, A Usategui, E A López-Jiménez, A Galindo, M Galindo
OBJECTIVE: To evaluate the usefulness of the uterine artery mean pulsatility index (mPI-UtA) and the sFlt-1/PlGF ratio in women with systemic lupus erythematosus (SLE) or antiphospholipid syndrome (APS) for the prediction of placental dysfunction-related adverse outcomes (AO), namely pre-eclampsia (PE) and intrauterine growth restriction (IUGR), and for differential diagnosis between PE and SLE flares. STUDY DESIGN: Observational prospective cohort study of 57 pregnant women with SLE or APS...
January 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29510235/treatment-of-antiphospholipid-syndrome-beyond-anticoagulation
#20
Chrisanna Dobrowolski, Doruk Erkan
Antiphospholipid syndrome (APS) is a systemic autoimmune disorder marked by thrombosis and/or pregnancy morbidity in the presence of antiphospholipid antibodies (aPL). At the present time, treatment is primarily focused on anticoagulation. However, there is increasing awareness of the mechanisms involved in APS pathogenesis, which has led to the trial of novel therapies targeting those mechanisms. Following a brief review of the etiopathogenesis of and current management strategies in APS, this paper focuses on the evidence for these potential, targeted APS treatments, e...
March 3, 2018: Clinical Immunology: the Official Journal of the Clinical Immunology Society
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