Antiphospholipid syndrome
DOI:
https://doi.org/10.24950/rspmi/revisao/4/2018Keywords:
Antibodies, Anticardiolipin, Antibodies, Antiphospholipid, Antiphospholipid Syndrome, StrokeAbstract
The antiphospholipid syndrome (APS) is defined by the development of venous and/or arterial thromboses, often multiple, and pregnancy morbidity (mainly, recurrent fetal losses), in the presence of antiphospholipid antibodies (aPL). Some estimates indicate that the incidence of the APS is around 5 new cases per 100 000 persons per year and the prevalence around 40-50 cases per 100 000 persons. The aPL are positive in approximately 13% of patients with stroke, 11% with myocardial infarction, 9.5% of patients with deep vein thrombosis and 6% of patients with pregnancy morbidity. Currently, there is consensus in treating APS patients with thrombosis with long-term oral anticoagulation and to prevent obstetric manifestations with the use of aspirin and heparin. This review summarizes the main knowledge on the clinical and therapeutic aspects of this syndrome.
Downloads
References
Cervera R, Espinosa, Khamashta MA. Antiphospholipid syndrome in systemic autoimmune diseases. 2nd ed. Amsterdam: Elsevier; 2016.
Cervera R, Asherson RA, Acevedo ML, Gomez-Puerta JA, Espinosa G, De La Red G, et al. Antiphospholipid syndrome associated with infections: clinical and microbiological characteristics of 100 patients. Ann Rheum Dis. 2004;63:1312-7.
Gómez-Puerta JA, Cervera R, Espinosa G, Aguiló S, Bucciarelli S, Ramos-Casals M, et al. Antiphospholipid antibodies associated with malignancies: clinical and pathological characteristics of 120 patients. Semin Arthritis Rheum. 2006;35:322-32.
Gómez-Puerta JA, Martin H, Amigo MC, Aguirre MA, Camps MT, Cuadrado MJ, et al. Long-term follow-up in 128 patients with primary antiphospholipid syndrome: do they develop lupus? Medicine. 2005;84:225-30.
Rodríguez-Pintó I, Moitinho M, Santacreu I, Shoenfeld Y, Erkan D, Espinosa G, et al. Catastrophic antiphospholipid syndrome (CAPS): Descriptive analysis of 500 patients from the International CAPS Registry.Autoimmun Rev. 2016;15:1120-4. doi: 10.1016/j.autrev.2016.09.010.
Durcan L, Petri M. Epidemiology of the Antiphospholipid Syndrome. In: Cervera R, Espinosa, Khamashta MA, editors. Antiphospholipid syndrome in systemic autoimmune diseases. 2nd ed. Amsterdam: Elsevier; 2016.p. 17-30.
Andreoli L, Chighizola CB, Banzato A, Pons-Estel GJ, Ramire de Jesus G, Erkan D. Estimated frequency of antiphospholipid antibodies in patients with pregnancy morbidity, stroke, myocardial infarction, and deep vein thrombosis: a critical review of the literature.Arthritis Care Res. 2013; 65: 1869-73. doi: 10.1002/acr.22066.
Cervera R, Espinosa G, Bucciarelli S, Gomez-Puerta JA, Font J. Lessons from the catastrophic antiphospholipid syndrome (CAPS) registry. Autoimmun Rev. 2006;6:81-4.
Cervera R, Bucciarelli S, Plasin MA, Gomez-Puerta JA, Plaza J, Pons-Estel G, et al. Catastrophic antiphospholipid syndrome (CAPS): descriptive analysis of a series of 280 patients from the "CAPS Registry". J Autoimmun. 2009;32:240- 5. doi: 10.1016/j.jaut.2009.02.008.
Espinosa G, Cervera R. Antiphospholipid syndrome: frequency, main causes and risk factors of mortality. Nat Rev Rheumatol. 2010; 6: 296-300. doi: 10.1038/nrrheum.2010.47.
Giannakopoulos B, Krilis SA. The pathogenesis of the antiphospholipid syndrome. N Engl J Med. 2013;368:1033-44. doi: 10.1056/NEJMra1112830.
Cervera R, Piette JC, Font J, Khamashta MA, Shoenfeld Y, Camps MT, et al. Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients. Arthritis Rheumatol. 2002;46:1019-27.
Cervera R, Khamashta MA, Shoenfeld Y, Camps MT, Jacobsen S, Kiss E, et al. Morbidity and mortality in the antiphospholipid syndrome during a 5-year period: a multicentre prospective study of 1000 patients. Ann Rheum Dis. 2009;68:1428-32. doi: 10.1136/ard.2008.093179.
Cervera R, Serrano R, Pons-Estel GJ, Ceberio-Hualde L, Shoenfeld Y, de Ramón E, et al. Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicentre prospective study of 1000 patients. Ann Rheum Dis. 2015; 74: 1011-8. doi: 10.1136/annrheumdis-2013-204838.
Ruffatti A, Calligaro A, Hoxha A, Trevisanuto D, Ruffatti AT, Gervasi MT, et al. Laboratory and clinical features of pregnant women with antiphospholipid syndrome and neonatal outcome. Arthritis Care Res. 2010;62:302-7. doi: 10.1002/acr.20098.
Sciascia S, Sanna G, Murru V, Roccatello D, Khamashta MA, Bertolaccini ML. GAPSS: the Global Anti-Phospholipid Syndrome Score. Rheumatology. 2013;52:1397-403. doi: 10.1093/rheumatology/kes388.
Wilson WA, Gharavi AE, Koike T, Lockshin MD, Branch DW, Piette JC, et al. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an international workshop. Arthritis Rheumatol. 1999;42:1309-11.
Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4:295- 306.
Kaul M, Erkan D, Sammaritano L, Lockshin MD. Assessment of the 2006 revised antiphospholipid syndrome classification criteria. Ann Rheum Dis. 2007;66:927-30.
Asherson RA, Cervera R, de Groot PG, Erkan D, Boffa MC, Piette JC, et al. Catastrophic antiphospholipid syndrome: International consensus statement on classification criteria and treatment guidelines. Lupus. 2003;12:530-4.
Cervera R, Font J, Gomez-Puerta JA, Espinosa G, Cucho M, Bucciarelli S, et al. Validation of the preliminary criteria for the classification of catastrophic antiphospholipid syndrome. Ann Rheum Dis. 2005;64:1205-9.
Legault K, Schunemann H, Hillis C, Yeung C, Akl EA, Carrier M, et al. McMaster RARE-Bestpractices clinical practice guideline on diagnosis and management of the catastrophic antiphospholipid syndrome. J Thromb Haemost. 2018 (in press). doi: 10.1111/jth.14192.
Espinosa G, Cervera R. Current treatment of antiphospholipid syndrome: lights and shadows. Nat Rev Rheumatol. 2015;11:586-96. doi: 10.1038/nrrheum.2015.88.
Chighizola CB, Andreoli L, Gerosa M, Tincani A, Ruffatti A, Meroni PL. The treatment of anti-phospholipid syndrome: A comprehensive clinical approach. J Autoimmun. 2018;90:1-27. doi: 10.1016/j.jaut.2018.02.003.
Cervera R, Rodríguez-Pintó I, Espinosa G. The diagnosis and clinical management of the catastrophic antiphospholipid syndrome: A comprehensive review. J Autoimmun. 2018;92:1-11. doi: 10.1016/j.jaut.2018.05.007.
Grika EP, Ziakas PD, Zintzaras E, Moutsopoulos HM, Vlachoyiannopoulos PG. Morbidity, mortality, and organ damage in patients with antiphospholipid syndrome. J Rheumatol. 2012;39:516-23. doi: 10.3899/jrheum.110800.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Medicina Interna
Open Access
