Clinical feature and anti-phospholipid antibody profiles of pregnancy failure in young women with antiphospholipid antibody syndrome treated with conventional therapy

Kaneko, Kayoko; Mishima, Shuko; Goto, Mikako; Mitsui, Mari; Tanigaki, Shinji; Oku, Kenji; Ozawa, Nobuaki; Inoue, Eisuke; Atsumi, Tatsuya; Sago, Haruhiko; Murashima, Atsuko

doi:10.1080/14397595.2017.1386845

Cited by 6 publications

(3 citation statements)

References 14 publications

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“…3,4 The current study highlighted the eight previous cases and the present two cases with APS developing cervical and cranial artery dissections that had common clinical characteristics, including young age, female preponderance, and few atherosclerotic risk factors, which was more evident compared to overall APS patients with ischemic stroke, as well as all CAD cases. 6,8–14 Interestingly, the current study explored the fact that previous cases reported from Western countries predominantly involved the ICA, whereas the present two cases had bilateral VAD, which was consistent with ethnic variations in overall CAD. It has been suggested that arterial endothelial dysfunction owing to the interaction between antiphospholipid antibodies and endothelial cells might contribute to the development of dissection, with coexisting local vasculitis and increased shear stress.…”

Section: Discussionsupporting

confidence: 78%

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Cerebral artery dissection secondary to antiphospholipid syndrome: A report of two cases and a literature review

Iseki

Yamashita

Ueno

et al. 2020

Lupus

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Introduction Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by thromboembolic events, including ischemic stroke or complications in pregnancy, and the presence of antiphospholipid antibodies. Cervical artery dissection (CAD) is not an uncommon cause of stroke in young adults. The concomitant presence of APS and CAD is extremely rare. Methods Two cases with APS who developed acute ischemic strokes related to CAD are reported. A comprehensive systematic literature search using the PubMed database was also conducted. Results In Case 1, a 36-year-old woman who had been diagnosed with systemic lupus erythematosus and had been repeatedly positive for lupus anticoagulant tests developed an ischemic stroke caused by a vertebral artery dissection (VAD). After admission, she had a recurrent ischemic stroke, followed by considerable changes in steno-occlusive lesions of the vertebrobasilar artery system. In Case 2, a 36-year-old man developed multiple brain infarcts due to bilateral VAD with aneurysmal formations and associated with pulmonary embolism. The anticardiolipin antibody titer was repeatedly elevated after stroke. The literature review identified 8 patients with CAD associated with APS, involving the internal carotid artery in 6 patients and the middle cerebral artery and vertebral artery in 1 patient each. The patients were predominantly young and female, infrequently had atherosclerotic vascular risk factors, and were positive for various antiphospholipid antibodies. Conclusions The current report described two rare cases of ischemic stroke caused by CAD secondary to APS, along with a review of the literature; the patients displayed characteristic clinical manifestations, implying specific mechanisms for cerebral artery disorders secondary to APS.

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Section: Discussionsupporting

confidence: 78%

“…After 3 months, IgG anticardiolipin antibody was repeatedly elevated (32 U/mL), the titers of IgG anticardiolipin were repeatedly higher than the 99 th percentile (10.2 U/mL), and the diagnostic criteria of APS were fulfilled. 1,8…”

Section: Resultsmentioning

confidence: 99%

Cerebral artery dissection secondary to antiphospholipid syndrome: A report of two cases and a literature review

Iseki

Yamashita

Ueno

et al. 2020

Lupus

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“…The positive LA test is the primary predictor of poor pregnancy outcomes in patients with or without SLE 10. More than one positive aPL test, especially the triple aPL-positivity, also contributes to the risk of pregnancy morbidity 11–13. Based on our univariate analysis, aPL-related obstetric outcomes were similar between LA-positive patients with triple, double, or single aPL positivity.…”

Section: Discussionmentioning

confidence: 68%

Pregnancy outcomes in antiphospholipid antibody positive patients: prospective results from the AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Clinical Database and Repository (‘Registry’)

Sevim¹,

Andrade²,

Banzato³

et al. 2022

Lupus Sci Med

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ObjectivesTo describe the outcomes of pregnancies in antiphospholipid antibody (aPL)-positive patients since the inception of the AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking Registry.MethodsWe identified persistently aPL-positive patients recorded as ‘pregnant’ during prospective follow-up, and defined ‘aPL-related outcome’ as a composite of: (1) Preterm live delivery (PTLD) at or before 37th week due to pre-eclampsia (PEC), eclampsia, small-for-gestational age (SGA) and/or placental insufficiency (PI); or (2) Otherwise unexplained fetal death after the 10th week of gestation. The primary objective was to describe the characteristics of patients with and without aPL-related composite outcomes based on their first observed pregnancies following registry recruitment.ResultsOf the 55 first pregnancies observed after registry recruitment among nulliparous and multiparous participants, 15 (27%) resulted in early pregnancy loss <10 weeks gestation. Of the remaining 40 pregnancies: (1) 26 (65%) resulted in term live delivery (TLD), 4 (10%) in PTLD between 34.0 weeks and 36.6 weeks, 5 (12.5%) in PTLD before 34th week, and 5 (12.5%) in fetal death (two associated with genetic anomalies); and (2) The aPL-related composite outcome occurred in 9 (23%). One of 26 (4%) pregnancies with TLD, 3/4 (75%) with PTLD between 34.0 weeks and 36.6 weeks, and 3/5 (60%) with PTLD before 34th week were complicated with PEC, SGA and/or PI. Fifty of 55 (91%) pregnancies were in lupus anticoagulant positive subjects, as well as all pregnancies with aPL-related composite outcome.ConclusionIn our multicentre, international, aPL-positive cohort, of 55 first pregnancies observed prospectively, 15 (27%) were complicated by early pregnancy loss. Of the remaining 40 pregnancies, composite pregnancy morbidity was observed in 9 (23%) pregnancies.

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Cluster analysis of antiphospholipid antibodies-associated adverse pregnancy outcome patients: based on a 13-years cohort study

Long,

Huang,

Cui

et al. 2023

Clin Exp Med

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Clinical feature and anti-phospholipid antibody profiles of pregnancy failure in young women with antiphospholipid antibody syndrome treated with conventional therapy

Cited by 6 publications

References 14 publications

Cerebral artery dissection secondary to antiphospholipid syndrome: A report of two cases and a literature review

Cerebral artery dissection secondary to antiphospholipid syndrome: A report of two cases and a literature review

Pregnancy outcomes in antiphospholipid antibody positive patients: prospective results from the AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Clinical Database and Repository (‘Registry’)

Cluster analysis of antiphospholipid antibodies-associated adverse pregnancy outcome patients: based on a 13-years cohort study

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