Classification of primary antiphospholipid syndrome as systemic lupus erythematosus: Analysis of a cohort of 214 patients

Paule, Romain; Morel, Nathalie; Guern, Véronique Le; Fredi, Micaela; Coutte, L.; Belhocine, M.; Mouthon, Luc; Jeunne, Claire Le; Chauvin, Anthony; Piette, Jean‐Charles; Costédoat-Chalumeau, Nathalie

doi:10.1016/j.autrev.2018.03.011

Cited by 25 publications

(13 citation statements)

References 37 publications

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“…HVD in APS patients is defined by the presence of valve lesions and/or moderate to severe valve dysfunction in the absence of a history of rheumatic fever or infective endocarditis (1). Valvular involvement was the earliest reported cardiac manifestation of APS (13) and is the most common cardiac manifestation of APS. It includes valvular thickening and valve vegetations (also referred as Libman-Sacks endocarditis) (14).…”

Section: Types Of Cardiac Involvement In Apsmentioning

confidence: 99%

“…Diffuse cardiomyopathy is a less frequently reported manifestation in APS. However, there are several reports describing a possible histopathological association between dilated cardiomyopathy and the presence of aPL, in the absence of conventional risk factors (13, 76–79). In these cases, autopsies revealed widespread occlusive microthrombosis of small myocardial arterioles and areas of micro-infarction surrounding affected arterioles, which led to extensive myocardial necrosis.…”

Section: Types Of Cardiac Involvement In Apsmentioning

confidence: 99%

“…ECHO revealed a large mobile apical thrombus, normal valves, and decreased left ventricular systolic function. Despite anticoagulation, the patient subsequently underwent a massive stroke and the thrombus was no longer present on a repeat ECHO study (13). Some reports describe thrombi appearing in all four cardiac chambers.…”

Section: Types Of Cardiac Involvement In Apsmentioning

confidence: 99%

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Cardiac Manifestations of Antiphospholipid Syndrome With Focus on Its Primary Form

et al. 2019

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Antiphospholipid syndrome (APS) is a multisystem autoimmune disease most commonly associated with recurrent arterial and venous thromboembolism and recurrent fetal loss. Other possible antiphospholipid antibody (aPL)-related clinical manifestations include cardiac involvement. The heart can be involved through immune mediated and /or thrombotic mechanisms. Mortality due to cardiovascular problems is elevated in APS. However, the cardiovascular risk in patients with primary APS (PAPS) compared with lupus-related APS is yet to be established. Cardiac symptoms of APS include valve abnormalities (thickening and vegetations), coronary artery disease (CAD), myocardial dysfunction, pulmonary hypertension, and intracardiac thrombi. Heart valve lesions are the most common cardiac manifestation, observed in approximately one third of PAPS patients and usually do not cause hemodynamic significance. Deposits of immunoglobulins including anticardiolipin (aCL), and of complement components, are commonly observed in affected heart valves from these patients. This suggests that an inflammatory process is initiated by aPL deposition, eventually resulting in the formation of valvular lesion. aPL may have a direct role in the atherosclerotic process via induction of endothelial activation. Multiple traditional and autoimmune-inflammatory risk factors are involved in triggering an expedited atherosclerotic arterial disease evident in APS. It is imperative to increase the efforts in early diagnosis, control of risk factors and close follow-up, in the attempt to minimize cardiovascular risk in APS. Clinicians should bear in mind that a multidisciplinary therapeutic approach is of paramount importance in these patients. This article reviews the cardiac detriments of APS, including treatment recommendations for each cardiac complication.

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Section: Types Of Cardiac Involvement In Apsmentioning

confidence: 99%

Section: Types Of Cardiac Involvement In Apsmentioning

confidence: 99%

Section: Types Of Cardiac Involvement In Apsmentioning

confidence: 99%

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Cardiac Manifestations of Antiphospholipid Syndrome With Focus on Its Primary Form

et al. 2019

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“…Indeed, baseline information suggested little difference between PAPS and SAPS patients in age and most clinical manifestations (Table 1). It had been estimated in previous studies that around 40% of patients with SLE have aPL, and APS may develop in up to 50-70% of patients with both SLE and aPL (29). Nevertheless, levels of IgG for four aPLs were significantly higher in both PAPS and SAPS group compared to HC, which suggested their diagnostic value.…”

Section: Discussionmentioning

confidence: 83%

Evaluation of the Diagnostic Value of Extra-criteria Antibodies for Antiphospholipid Syndrome Patients in a Chinese Cohort

Xie

et al. 2021

Preprint

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Objective： Although specific anti-phospholipids antibodies (aPLs) have been used in the diagnosis of the antiphospholipid syndrome (APS) for years, new biomarkers are required to increase its diagnostic as well as risk-predictive power. This study aimed to explore the value of several extra-criteria aPLs in a Chinese cohort. Methods： A total of 312 patients including 100 patients diagnosed with primary APS, 51 with APS secondary to SLE, 71 with SLE, and 90 health controls were recruited. Serum anticardiolipin (aCL) IgG/IgM/IgA, anti-β2-glycoprotein I (aβ2GPI) IgG/IgM/IgA, anti-phosphatidylserine/prothrombin antibodies (aPS/PT) IgG/IgM, anti-annexin A5 antibodies (aAnxV) IgG/IgM were tested using ELISA kits. Results： Totally 30.46% and 6.62% of patients with APS were positive for aCL or aβ2GPI IgA respectively, while 39.07% and 24.50% were positive for aAnxV or aPS/PT for at least one antibodies (IgG or IgM). The addition test of aCL IgA and aAnxV IgM assist in identifying seronegative APS patients, and IgG aANxV was linked with stroke. Conclusion： Detection of aCL IgA, aβ2GPI IgA, aAnxV IgG/M, and aPS/PT IgG/M as biomarker provide additive value in APS diagnosis, and would help in risk prediction for APS patients in medical practice.

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“…[5,6] These complications often consist of fetal loss, miscarriage, intrauterine growth restriction, preeclampsia, fetal death, and preterm delivery. [7–9] Previous study has reported that APS can account for 15% recurrent abortion (RCA). [10–11] The incidence of APS is about 5 individuals per 100,000 patients/y, and its prevalence is about 40 to 50 patient every 100,000 subjects.…”

Section: Introductionmentioning

confidence: 99%

Low molecular weight heparin monotherapy for recurrent abortion with antiphospholipid system

Ni¹,

Sun²,

Zhao

et al. 2019

Medicine

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Background: Previous clinical studies reported low molecular weight heparin (LMWH) monotherpay has been utilized for the treatment of recurrent abortion (RCA) with antiphospholipid system (APS). However, its efficacy is still inconclusive. This systematic review aims to assess its efficacy and safety for patients with RCA and APS. Methods: A systematic literature search for article up to February 2019 will be conducted in 9 databases: Cochrane Library, EMBASE, MEDILINE, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Information, and Wanfang Data. Inclusion criteria are randomized control trials of LMWH monotherpay for patients with RCA and APS. The Cochrane risk of bias tool will be used to evaluate the methodological quality for each qualified study. The summary results will be showed by using fixed-effects and random-effects models for pooling the data based on the heterogeneity of included studies. Results: This systematic review will assess the clinical efficacy and safety of LMWH monotherpay in treating RCA with APS. The primary outcome is pregnancy loss. The secondary outcomes include frequency of preterm delivery, live birth rates, maternal and fetal complications, as well as adverse events. Conclusion: The findings of this study will summarize the present evidence to judge whether LMWH monotherpay is an effective therapy for patients with RCA and APS. Dissemination and ethics: The findings of this study will be published by through peer-reviewed journals. This study does not needs ethic documents, because it will not analyze individual patient data. Systematic review registration: PROSPERO CRD42019121064.

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Classification of primary antiphospholipid syndrome as systemic lupus erythematosus: Analysis of a cohort of 214 patients

Cited by 25 publications

References 37 publications

Cardiac Manifestations of Antiphospholipid Syndrome With Focus on Its Primary Form

Cardiac Manifestations of Antiphospholipid Syndrome With Focus on Its Primary Form

Evaluation of the Diagnostic Value of Extra-criteria Antibodies for Antiphospholipid Syndrome Patients in a Chinese Cohort

Low molecular weight heparin monotherapy for recurrent abortion with antiphospholipid system

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