66 Antiphospholipid syndrome – cinical and immunological correlations and atherosclerosis

Abstract

Background and aimsIn recent years, it is found that role in atherogenesis plays inflammatory component of immune response. In recent years found unarguably data for accelerated development of atherosclerotic plaques in patients with APS.Our aim is to investigate the frequency of cardiovascular events and atherosclerosis in patients with primary and secondary antiphospholipid syndrome compared to healthy individuals and patients with systemic lupus erythematosus without antiphospholipid antibodies.MethodsWe studied 99 patients with APS, 13 SLE and 32 healthy controls. They were tested for aPL antibodies (aCL,anti-b2gp1, anti-prothrombin), ANA-screen, ANA - profile and standart laboratory.We examine Intima-Media thickness of carotit arteries and Calcium score of: a. coronaria sinister, a. anterior descendens sinister, a. circumflexa sinister, a. coronaria dexter, Aorta, Valvaorte to validate the atheroslerosis.ResultsWe found strong, statistically significant correlation between aCL antibodies and the presence of plaques in the left common carotid artery (p=0.041) and absent a correlation between aPL titers and presence of carotid plaques. In the group with APS, 33,3% (14) establishes a positive calcium score of coronary artheries, 11.9% (5) positive for aorta, Aortic valve Absent deposits, In the control group positive calcium score is one person (5.88%).ConclusionsIt was established the relationship of antiphospholipid syndrome with the process of atherosclerosis.The presence of atherosclerotic plaques is not associated with traditional risk factors.Not establish a connexion between antiphospholipid antibodies and IMT.Proven connexion between aCL and carotid plaques.Not establish correlation between aPL and Ca score.Persons with APS have a higher incidence of Calcium score versus healthy controls.

A case report of a patient with a live born child from the 14th pregnancy after 13 spontaneous abortion, diagnosed with systemic lupus erythematosus and antiphospholipid syndrome

“…танни аборти, мъртви раждания), при наличието на хетерогенна група антитела -антифосфолипидни антитела (aPL) [1,2].…”

“…При пациентите със SLE най-често се наблюданат антикардиолипинови антитела -aCL (12-44%), лупусен антикоагулант -LAC (15-34%), β2GPI (10-19%) [1,2,5,6,7,8].…”

“…В тази клинична обстановка прееклампсията обикновено е ранна и тежка и може да бъде усложнена от хемолиза, повишени чернодробни ензими и нисък брой на тромбоцитите (известни като HELLP синдром). Тясната връзка между a heterogeneous group of antibodies -antiphospholipid antibodies (aPL) [1,2].…”

“…In patients with SLE, the most commonly observed are anti-cardiolipin antibodies -aCL (12-44%), lupus anticoagulant -LAC (15-34%), β2GPI (10-19%) [1,2,5,6,7,8].…”

“…Първоначално е лансирана тезата за интраплацентарна тромбоза с последващ контакт между кръвта на майката и плода, като патогенетичен механизъм за фетална смърт и усложнеия на бремеността [1,2]. Изследвания на хистологичен материал от плацента и абортивен материал при жени с АФС показват наличието не само на съдова тромбоза в плацентарен съд, но и данни за хронично и остро възпаление.…”