Catastrophic antiphospholipid syndrome: Where do we stand?

Abstract

Micrometer‐sized monodispersed mesoporous silica spheres with adjustable particle diameter and adjustable pore structure were successfully prepared. Drops of a silica sol were injected by a microfluidic device into a heated oil bath where the droplets solidified during sedimentation. Drop size was varied by control of the rates of the oil flow past the silica sol injector. The silica sol was made by prehydrolysis of tetraethyl orthosilicate (TEOS) in an aqueous acidic solution using a triblock copolymer as the template. Acrylamide monomer was added in the sol after prehydrolysis to accelerate the solidification rate of drops in the oil bath. The amount of monomer was used to control the pore sizes in the silica particles. The effect of synthesis conditions on the morphology and pore structure of spheres was investigated. Silica spheres with different surface morphology and internal structure were obtained by changing the composition of sedimentation medium. Pore diameter and pore‐size distribution can be adjusted effectively by controlling the concentration of silica source, acid or polymeric monomer in the aqueous phase. The prepared silica spheres have high‐surface area (>550 m2/g), large pore volume (>1.1 cm3/g) and large amount of macropores. High‐protein adsorption capacity (520mg/g) was achieved in the adsorption experiments of bovine serum albumin (BSA). Pore structure of silica spheres was demonstrated to be a crucial factor to determine the protein adsorption capacity. © 2007 American Institute of Chemical Engineers AIChE J, 2008

The clinical significance of antiphospholipid antibodies in systemic lupus erythematosus

“…The prevalence of "aPL-nephropathy" in SLE patients without aPL varies between 4%-16 %, whereas 25%-39% of the aPL-positive SLE patients have "aPL-nephropathy" (92,94 Catastrophic antiphospholipid syndrome Encountered in less than 1% of APS patients, catastrophic APS is characterized by accelerated widespread small/medium vessel thromboses with unusual organ involvement and has a mortality of 30%-50% despite aggressive multimodal intensive treatment (102)(103)(104).…”

Antiphospholipid syndrome: laboratory detection, mechanisms of action and treatment

“…Definite criteria for CAPS diagnosis include (i) the involvement of at least three organs, systems or tissues, (ii) development of clinical manifestations at the same time or within 1 week, (iii) confirmation by histopathology of small-vessel occlusion and (iv) laboratory criteria for APS [96][97][98]. Despite the low incidence of CAPS (<1%), it is a life-threatening medical condition with a case fatality rate of 50%.…”

How I treat the antiphospholipid syndrome

“…120 Due to the rarity or catastrophic APS, RCTs are not available to guide treatment. Investigators have reported several interventions that may be of benefit [119][120][121] and are used by us to guide treatment of these patients. The cornerstone of treatment appears to be the prompt use of anticoagulation (in the absence of concurrent hemorrhage) and the identification and treatment of possible underlying infection.…”