Antiphospholipid Syndrome with Monoclonal Gammopathy—A Mechanism for Recurrent Thrombosis?

Doyle, Andrew J.; Breen, Karen; Hunt, Beverley J.

doi:10.1055/a-1366-9379

Cited by 7 publications

(9 citation statements)

References 29 publications

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“…In addition, a history, complete physical examination, and biochemical tests, such as serum paraprotein and light chain assay, should be performed to exclude solid organ or haematological malignancies. Our recent study showed that some APS patients with recurrent thrombosis despite adequate anticoagulation had a paraprotein [49]. Doyle et al showed that the percentage of other autoimmune disorders among these nine patients was low and there was a predilection for arterial thrombosis [49].…”

Section: Recurrent Thrombosis While On Treatmentmentioning

confidence: 76%

Clinical Management of Thrombotic Antiphospholipid Syndrome

Tumian

Hunt

2022

JCM

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Thrombotic manifestations of antiphospholipid syndrome are often a therapeutic dilemma and challenge. Despite our increasing knowledge of this relatively new disease, many issues remain widely unknown and controversial. In this review, we summarise the latest literature and guidelines on the management of thrombotic antiphospholipid syndrome. These include the laboratory assays involved in antiphospholipid antibodies (aPL) testing, the use of direct oral anticoagulants in secondary prevention, management of recurrent thrombosis, individuals with isolated aPL, and catastrophic antiphospholipid syndrome. Treatment aims to prevent the potentially fatal and often disabling complications of APS with antithrombotic and cardiovascular risks prevention strategies. Some insights and updates on topical issues in APS are provided. We also include our current practice, which we believe is the pragmatic approach based on the currently available evidence.

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Section: Recurrent Thrombosis While On Treatmentmentioning

confidence: 76%

Clinical Management of Thrombotic Antiphospholipid Syndrome

Tumian

Hunt

2022

JCM

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“…No patients had a diagnosis of malignancy. Patients 1 and 3 were tested for monoclonal gammopathy 16 and JAK2 V617F, 17 neither of which were present. Patient 2 has not been tested for these.…”

Section: Resultsmentioning

confidence: 99%

The use of fondaparinux and rituximab for recurrent thrombotic events in antiphospholipid syndrome

Sayar

Burke

Mittal

et al. 2022

Lupus

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Limited evidence exists to guide the management of recurrent thrombosis occurring despite therapeutic anticoagulation in patients with thrombotic antiphospholipid syndrome (APS). In this case series, fondaparinux, with or without an antiplatelet agent, provided an effective and safe option in three patients with thrombotic APS, all two triple and one single positive for antiphospholipid antibodies, who had recurrent venous and/or arterial thromboembolism. Rituximab was also used in all patients. Recurrent events occurred despite therapeutic anticoagulation, including at high-intensity, with warfarin and subsequent low-molecular-weight heparin. There were no major bleeding events. Adjunctive therapies used for thrombosis included catheter-directed thrombolysis and rituximab.

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“…Because APS and monoclonal gamma globulin disease increase the risk of thrombosis, thrombotic events may be caused by the combined effect of these conditions ( 52 ). Recently, Doyle et al ( 53 ) described a new discovery of a small number of patients with thrombotic APS and monoclonal gamma globulin receiving anticoagulation therapy having a higher incidence of recurrent thrombosis than patients without accessory protein. When thrombotic APS develops, long-term anticoagulation is required.…”

Section: Discussionmentioning

confidence: 99%

A rare case of schizophrenia coexistence with antiphospholipid syndrome, β-thalassemia, and monoclonal gammopathy of undetermined significance

Jin

Cheng

et al. 2023

Front. Psychiatry

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A patient with schizophrenia who was treated with chlorpromazine developed lupus anticoagulant (LA) and antiphospholipid syndrome (APS). On protein electrophoresis, a monoclonal immunoglobulin A peak was seen in this patient, defining a condition of monoclonal gammopathy of undetermined significance. Additionally, β-thalassemia was diagnosed with the CD41-42 genotype. This condition is extremely rare, particularly in patients with schizophrenia and APS. We present a case of a patient with schizophrenia and secondary APS who had a positive LA, a significantly prolonged activated partial thromboplastin time, endogenous coagulation factor deficiency and inhibitor, no bleeding, and an unexpected finding of β-thalassemia and monoclonal IgA. Following that, a literature review on the disorders was presented.

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Antiphospholipid Syndrome with Monoclonal Gammopathy—A Mechanism for Recurrent Thrombosis?

Abstract: Not Applicable

Cited by 7 publications

References 29 publications

Clinical Management of Thrombotic Antiphospholipid Syndrome

Clinical Management of Thrombotic Antiphospholipid Syndrome

The use of fondaparinux and rituximab for recurrent thrombotic events in antiphospholipid syndrome

A rare case of schizophrenia coexistence with antiphospholipid syndrome, β-thalassemia, and monoclonal gammopathy of undetermined significance

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