Presentation
We present a case of 26-year-old female who developed massive bilateral pulmonary emboli after being started on oral contraceptive pills. [ncbi.nlm.nih.gov]
In prior cases patients presented with gastrointestinal bleeding, abdominal pain, or an acute abdomen without gastrointestinal perforation. [connection.ebscohost.com]
Our case suggests that MFS presenting with proptosis and pain may be associated with serum anti-GQ1b antibodies and IgM anti-cardiolipin antibody. Author(s): Xueliang Qi, Rui Chen, Jiaomei Jiang, Ming Zhang Abstract Full Text PDF [alliedacademies.org]
systemic lupus erythematosus, but others present only with a history of frequent arterial and venous thrombi or pregnancy loss. [medical-dictionary.thefreedictionary.com]
Entire Body System
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Recurrent Pulmonary Embolism
Recurrent pulmonary embolism is assumed to be the leading cause of pulmonary hypertension in APS. 6 The prevalence of aPL in patients with chronic thromboembolic pulmonary hypertension varies between 10% 22, 23 and 20%. 24 It is likely that chronic thromboembolic [ard.bmj.com]
Hematological
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Easy Bruising
For example, a low level of platelets, which can cause easy bruising and a type of anaemia called haemolytic anaemia. Avascular necrosis of the bone (also called osteonecrosis). Bones are a living part of the body and need a blood supply. [patient.info]
Gastrointestinal
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Acute Abdomen
In prior cases patients presented with gastrointestinal bleeding, abdominal pain, or an acute abdomen without gastrointestinal perforation. [ncbi.nlm.nih.gov]
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Severe Abdominal Pain
He presented a six-hour history of severe abdominal pain and his bowels had not been opened for 72 hours. An abdominal X-ray revealed faecal loading... Necrosis y estenosis por colitis isquà mica no oclusiva. [connection.ebscohost.com]
Neurologic
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Stroke
Recent evidence suggests that antiphospholipid antibodies play a role in approx. 20% of strokes, esp. in patients who do not have common risk factors for stroke. [medical-dictionary.thefreedictionary.com]
MacGregor, S. and Pasternak, J. (1992) Neely S, Fetal Stroke Associated with Elevated Maternal Anticardiolipin Antibodies. [scirp.org]
(IgA) Identify risk of thrombosis, pregnancy morbidity, thrombocytopenia, and stroke. 4663 Cardiolipin Antibody (IgM) Identify APS, with lower specificity than IgG; identify risk of thrombosis, pregnancy morbidity, thrombocytopenia, and stroke. [questdiagnostics.com]
Ischemic stroke The optimal treatment of patients with APS who present with ischemic stroke is controversial. [cancertherapyadvisor.com]
If a blood clot forms in the arms or legs, it may travel to the lungs ( pulmonary embolism ), brain (stroke) or heart ( heart attack ). [cedars-sinai.edu]
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Areflexia
The neurological examination revealed bilateral ptosis, proptosis with serious tenderness, ophthalmoplegia with dull pupil reaction to light, and areflexia. There was no ataxia. [alliedacademies.org]
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Neonatal Seizures
De Vries, T. and Sinnige, L. (1997) An Unusual Case of Neonatal Seizures in a New Born Infant. [scirp.org]
Workup
In addition to the standard protocol of investigations in SLE, anticardiolipin antibody (aCL) status was determined during the initial workup and was confirmed after 6 weeks. Renal biopsy was studied by a senior experienced pathologist. [indianjnephrol.org]
Antiphospholipid syndrome workup. Medscape. Available online at . Accessed 12/27/2016. Moake, J. (Revised 2016 September) Antiphospholipid antibody syndrome. Merck Manual Professional Version. Available online at . Accessed 12/27/2016. [labtestsonline.it]
See Presentation and Workup. Multiple terms for APS exist. Unfortunately, some synonyms can be confusing. [emedicine.medscape.com]
Treatment
The presence of the antibody will support a diagnosis but cannot be used alone for diagnosis or treatment. [ncbi.nlm.nih.gov]
This syndrome may require treatment with anticoagulant medications. [health.am]
Specific chapters describe the treatment of the different symptoms, therapies of value in avoiding recurrences, and innovative treatment approaches. [books.google.com]
Although cardiac transplantation is a succesful treatment for these patients, the shortage of donor hearts has led surgeons to seek other options. Ventricular assist device (VAD)... [connection.ebscohost.com]
et al. (1992) Repeated Fetal Losses Associated with Antiphospholipid Antibodies: A Collaborative Randomized Trial Comparing Prednisone to Low-Dose Heparin Treatment. [scirp.org]
Prognosis
What is the prognosis of antiphospholipid syndrome? The prognosis of antiphospholipid syndrome depends on the character and the intensity of its manifestations. Earlier treatment will tend to have better outcomes. [medicinenet.com]
[…] does not meet this criterion pregnancy morbidity: 3 miscarriages laboratory criteria (detected on 2 occasions on testing at least 12 weeks apart) 7 : anticoardiolipin antibodies anti-beta2-glycoprotein I antibodies lupus anticoagulant Treatment and prognosis [radiopaedia.org]
[…] antibodies) react against platelet membranes or prothrombin-platelet membrane complex, activating endothelial cells and platelets this activates complement-mediated thrombosis Associated conditions SLE other autoimmune diseases preeclampsia or eclampsia Prognosis [medbullets.com]
Prognosis People with primary APS generally lead normal, healthy lives with the help of medication and lifestyle changes. People with secondary APS generally have a similar prognosis. [drugs.com]
Etiology
Shoenfeld received the EULAR prize in 2005, in Vienna, Austria: "The infectious etiology of anti-phospholipid syndrome". [books.google.com]
The presumed etiologies are numerous; however, it typically develops spontaneously in the absence of major vasculature occlusion. It includes a wide clinical spectrum ranging from mild... [connection.ebscohost.com]
Etiology The disorder can be primary ( primary antiphospholipid syndrome ) or secondary (i.e. associated with systemic lupus erythematosus ). [radiopaedia.org]
[…] experience one of the following should be screened for antibodies associated with APS : Arterial thrombosis or unprovoked venous thrombosis before 50 years of age Recurrent thrombosis Thrombosis at an unusual site Thrombotic microangiopathy of unknown etiology [arupconsult.com]
The clinical manifestations of CTEPH are similar to those of PH of any etiology and include progressive dyspnea with exertion, decreased exercise tolerance, and fatigue. [phaonlineuniv.org]
Epidemiology
This Primer provides an update on the epidemiology, pathogenesis, diagnosis and therapeutic aspects and offers an outlook on future research topics. [nature.com]
Introduction Clinical definition an autoimmune disorder, often associated with systemic lupus erythematosus (SLE), characterized by thromboses and recurrent spontaneous abortions Epidemiology incidence increases with age demographics female male affects [medbullets.com]
[…] arterioles, and focal atrophy. [4] A “two-hit” theory has been proposed in which a second risk factor (age, hypertension, diabetes, obesity, smoking, pregnancy, surgery, other genetic hypercoagulable state) incites the thrombotic effects of aPL. [5] Epidemiology [emedicine.medscape.com]
A recent epidemiological study was unable to identify clinical or immunological predictors of thrombotic events, pregnancy morbidity, or mortality ( 80 ). [clinchem.aaccjnls.org]
Pathophysiology
Pier Luigi Meroni Springer, ٢٠/١١/٢٠١٤ - 267 من الصفحات This book, part of the series Rare Diseases of the Immune System, offers comprehensive, up-to-date coverage of the pathophysiology and management of the antiphospholipid syndrome (APS). [books.google.com]
The pathophysiology is not precisely known. Diagnosis is by blood tests. Anticoagulation is often used for prevention and treatment. [merckmanuals.com]
The pathophysiological hallmark is thrombosis, but other factors such as complement activation might be important. [natureasia.com]
I could not find good source which explains its pathophysiology and laboratory results. A. First, before we get into the antiphospholipid syndrome, we need to talk about antiphospholipid antibodies. [pathologystudent.com]
Prevention
Although in vivo assays that allow assessment of the pathogenic procoagulant activity of patient autoantibodies have recently been developed, the complex nature of the mixed species prevented determination of the particular species responsible for in [pnas.org]
Thromboses caused by the syndrome are treated and prevented with heparin, warfarin, corticosteroids, or, in some instances, immunosuppressant drugs such as cyclophosphamide. CAUTION! [medical-dictionary.thefreedictionary.com]
However, medicines can help prevent complications. The goals of treatment are to prevent blood clots from forming and keep existing clots from getting larger. You may have APS and another autoimmune disorder, such as lupus. [nhlbi.nih.gov]