Extra-criteria manifestations of antiphospholipid syndrome: Risk assessment and management

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art_RADIN_Extracriteria_manifestations_of_antiphospholipid_syndrome_Risk_assessment_and_2018.PDF (330.98 KB)
Citações na Scopus
36
Tipo de produção
article
Data de publicação
2018
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
W B SAUNDERS CO-ELSEVIER INC
Autores
RADIN, Massimo
SCIASCIA, Savino
Citação
SEMINARS IN ARTHRITIS AND RHEUMATISM, v.48, n.1, p.117-120, 2018
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objectives: Extra-criteria manifestations of antiphospholipid syndrome (APS) might impact on prognosis and morbidity of the disease. In this study, we aimed to evaluate a population of patients with primary APS (PAPS) whether the extra-criteria manifestations were more frequently found in subjects with higher adjusted Global APS Score (aGAPSS) values when compared to patients with thrombotic and/or obstetric APS (""criteria"" manifestations) only. Methods: Clinical records were analyzed to retrieve extra-criteria manifestation of APS, cardiovascular risk factors and antiphospholipid antibodies profile. The aGAPSS was calculated by adding the points, as follows: 3 for hyperlipidaemia, 1 for arterial hypertension, 5 for anticardiolipin antibodies IgG/IgM, 4 for anti-beta 2 glycoprotein I IgG/IgM, and 4 for lupus anticoagulant. Results: This retrospective multicenter study included 89 consecutive PAPS [mean age 43.1 (S.D. +/- 12.9), female 67%, 52% arterial and 65% venous]. Twenty-seven patients (30.3%) had a history of livedo, 19 (21.3%) had a history of confirmed thrombocytopenia, 3 (3.4%) had biopsy-proven antiphospholipid antibodies (aPL)-related nephropathy and 3 (3.4%) had a history of valvulopathy. Patients with extra criteria manifestations presented a mean aGAPSS significantly higher [mean 10.30 (S.D. +/- 3.57, range: 4-17) vs mean 8.16 (S.D. +/- 3.52;range: 4-16, p = 0.005). When comparing patients with and without extra-criteria manifestations, the first group had significantly higher incidence of anti-beta 2GPI antibodies positivity (59% and 33%, respectively, p = 0.015), double aPL positivities (53% and 31%, respectively, p = 0.034), cerebrovascular events history (52% and 24%, respectively, p = 0.007) and arterial hypertension (52% and 24%, respectively, p = 0.007). Conclusions: Our results suggest that patients with higher aGAPSS, might be at higher risk for developing extra-criteria manifestations of APS and should therefore undergo a thorough laboratory and instrumental evaluation.
Palavras-chave
Antiphosphospholipid syndrome, APS, Livedo, Thrombocytopenia, GAPSS, aGAPSS, Risk score, Thrombosis
URI
https://observatorio.fm.usp.br/handle/OPI/28380
Referências
  1. Abreu MM, 2015, AUTOIMMUN REV, V14, P401, DOI 10.1016/j.autrev.2015.01.002
  2. Amengual O, 1996, BRIT J RHEUMATOL, V35, P1239
  3. Amigo MC, 2014, LUPUS, V23, P1259, DOI 10.1177/0961203314534307
  4. Andreoli L, 2013, ARTHRIT CARE RES, V65, P1869, DOI 10.1002/acr.22066
  5. BRANDT JT, 1995, THROMB HAEMOSTASIS, V74, P1185
  6. Cervera R, 2002, ARTHRITIS RHEUM, V46, P1019, DOI 10.1002/art.10187
  7. Chighizola CB, 2015, LUPUS, V24, P980, DOI 10.1177/0961203315572714
  8. D'Agostino RB, 2008, CIRCULATION, V117, P743, DOI 10.1161/CIRCULATIONAHA.107.699579
  9. Erkan D, 2012, LUPUS, V21, P695, DOI 10.1177/0961203312437810
  10. Mosteirin NF, 2017, LUPUS, V26, P1328, DOI 10.1177/0961203317703493
  11. Harris EN, 1986, CLIN EXP IMMUNOL, V68, P22
  12. Massimo Radin, 2017, EUR J NEUROL, DOI [10.1111/ene.13499, DOI 10.1111/ENE.13499]
  13. Miyakis S, 2006, J THROMB HAEMOST, V4, P295, DOI 10.1111/j.1538-7836.2006.01753.x
  14. Nochy D, 2003, ANN MED INTERNE, V154, P51
  15. Oku K, 2015, LUPUS, V24, P774, DOI 10.1177/0961203314561284
  16. Pengo V, 2009, J THROMB HAEMOST, V7, P1737, DOI 10.1111/j.1538-7836.2009.03555.x
  17. Radin M, 2017, INT J CARDIOL, V240, P72, DOI 10.1016/j.ijcard.2017.02.155
  18. Rosa RF, 2015, CURR RHEUMATOL REP, V17, DOI 10.1007/s11926-015-0502-7
  19. Sciascia S, 2014, LUPUS, V23, P1286, DOI 10.1177/0961203314541317
  20. Sciascia S, 2017, NAT REV RHEUMATOL, V13, DOI 10.1038/nrrheum.2017.124
  21. Sciascia Savino, 2016, Clin Mol Allergy, V14, P6, DOI 10.1186/s12948-016-0043-2
  22. Sciascia S, 2015, RHEUMATOLOGY, V54, P134, DOI 10.1093/rheumatology/keu307
  23. Sciascia S, 2015, ANN RHEUM DIS, V74, P2028, DOI 10.1136/annrheumdis-2014-205663
  24. Sciascia S, 2014, ARTHRIT CARE RES, V66, P1915, DOI 10.1002/acr.22388
  25. Sciascia S, 2013, RHEUMATOLOGY, V52, P1397, DOI 10.1093/rheumatology/kes388
  26. Sciascia Savino, 2017, RHEUMATOLOGY OXFORD
  27. Zuily S, 2015, RHEUMATOLOGY, V54, P2071, DOI 10.1093/rheumatology/kev238

Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/17
Artigos e Materiais de Revistas Científicas - ODS/03