The digestive system involvement of antiphospholipid syndrome: pathophysiology, clinical characteristics, and treatment strategies

Abstract

Antiphospholipid syndrome (APS) is an autoimmune disease mainly characterised by vascular thrombosis and pregnancy morbidity. APS has broad spectrum of clinical manifestations. The digestive system involvement of antiphospholipid syndrome is a critical but under-recognised condition. Digestive system involvement may be the result of direct (autoimmune-mediated) or indirect (thrombotic) mechanisms. Liver is the most commonly involved organ, followed by intestines, oesophagus, stomach, pancreas and spleen. This review describes possible digestive system manifestations in APS patients, and illustrates the epidemiology and possible pathophysiology of APS. The role of different treatment strategies in the management of digestive system manifestations of APS were also discussed. Key messages Antiphospholipid syndrome is a multi-organ, multi-system disease and its clinical manifestation spectrum is gradually expanding. Since the first diagnosis of APS, the clinical manifestations of digestive system have been reported successively. This narrative review describes the major digestive system manifestations of APS and illustrates the epidemiology, pathophysiology and the role of therapeutic strategies of these patients.

Acute esophageal necrosis syndrome as a rare complication of diabetic ketoacidosis

“…[ 2 ] The incidence is estimated between 0.01% and 0.28%. [ 3 , 4 ] It affects men preferentially with a peak of incidence in the sixth decade. Risk factors are immunocompromised patients, diabetic, neoplasia, hypertension, coronary artery disease, antiphospholipid syndrome [ 3 , 4 ] and alcohol abuse.…”

“…[ 3 , 4 ] It affects men preferentially with a peak of incidence in the sixth decade. Risk factors are immunocompromised patients, diabetic, neoplasia, hypertension, coronary artery disease, antiphospholipid syndrome [ 3 , 4 ] and alcohol abuse. [ 2 ] The symptoms are upper GI bleeding with hematemesis and melena, dysphagia, abdominal pain, hemodynamic instability.…”

Antiphospholipid syndrome, thrombosis and multidisciplinary management

“…Hepatic veno‐occlusive disease such as Budd‐Chiari syndrome and splenic infarcts are the commonest manifestations in the liver and spleen. However, non‐thrombotic manifestations, while rare, have been reported and include nodular regenerative hyperplasia and acute pancreatitis 14 …”

“…However, non-thrombotic manifestations, while rare, have been reported and include nodular regenerative hyperplasia and acute pancreatitis. 14…”

Paralytic Ileus as a Presentation of Antiphospholipid Syndrome in a Patient with Renal Angiomyolipoma: A Case Report

“…The manifestations of APS vary greatly depending on the location of thrombosis. If there is thrombosis causing mesenteric ischemia, then gastrointestinal manifestations can occur [5]. These symptoms include postprandial abdominal pain, weight loss, and paralytic ileus.…”