Antiphospholipid Antibodies and Autoimmune Haemolytic Anaemia: A Systematic Review and Meta-Analysis

Merashli, Mira; Bucci, Tommaso; Pastori, Daniele; Pignatelli, Pasquale; Arcaro, Alessia; Gentile, Fabrizio

doi:10.3390/ijms21114120

Cited by 16 publications

(11 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, it is widely accepted that the main mechanism underlying thrombosis in AIHA is the autoantibody-induced RBC membrane alteration that leads to hemolysis [ 64 , 65 ]. In addition, in line with the common association between autoimmune diseases and APA [ 66 ], up to 60% of patients with AIHA develop APA, whose positivity is a well-known risk factor for both arterial and venous thrombosis [ 1 , 67 , 68 ]. Hence, one would expect that, during acute hemolysis, the presence of APA further unbalances the hemostatic equilibrium.…”

Section: Pathophysiology Of Thrombosis In Immune Mediated Hemolysismentioning

confidence: 99%

Thrombotic Complications in Patients with Immune-Mediated Hemolysis

Capecchi

Ciavarella

Artoni

et al. 2021

JCM

View full text Add to dashboard Cite

Autoimmune hemolytic anemias are rare and heterogeneous disorders characterized by hemolysis, which is a well-recognized risk factor for thrombosis. The most common immune-mediated anemias are represented by autoimmune hemolytic anemia and paroxysmal nocturnal hemoglobinuria, both associated with a high rate of thrombosis. Multiple pathophysiological mechanisms for thrombosis have been proposed, involving hemolysis itself and additional effects of the immune system. Despite the increasing awareness of the thrombotic risk in these conditions, evidence-based guidance on prevention and management of thrombotic events is lacking. We herein report available evidence on epidemiological data on thrombosis and thrombophilia in immune-mediated hemolysis, together with possible underlying pathophysiological mechanisms. In addition, we summarize current recommendations for treatment of thrombosis in immune-mediated hemolysis. In particular, we address the issue of thrombotic complications treatment and prophylaxis by proposing a therapeutic algorithm, focusing on specific situations such as splenectomy and pregnancy.

show abstract

Section: Pathophysiology Of Thrombosis In Immune Mediated Hemolysismentioning

confidence: 99%

Thrombotic Complications in Patients with Immune-Mediated Hemolysis

Capecchi

Ciavarella

Artoni

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…Of the anti-phospholipid antibodies, anticardiolipin was found in the highest frequency (27%), followed by lupus anticoagulant (2.8%) and beta 2 glycoprotein (1.4%), which is consistent with previous studies. 24 Neither of the lupus-specific or lupus non-specific dermatological manifestations was shown to have any significant correlation with nephritis or neuropsychiatric involvement. Its cause may be because disease activity involving internal organs may be independent of the obvious clinical features like rash and LE-specific skin lesions are T cell-mediated immune responses.…”

Section: Discussionmentioning

confidence: 92%

Clinico-Immunological Profile of Systemic Lupus Erythematosus Patients in Pakistan and Their Correlation

Khan¹,

Mushthaq²,

Sameera³

et al. 2022

PAFMJ

View full text Add to dashboard Cite

Objective: To see the clinical and immunological profile of systemic lupus erythematosus (SLE) patients and their correlation with the central nervous system and renal involvement. Study Design: Cross-sectional study. Place and Duration of Study: Fauji Foundation Hospital Rawalpindi from Sep 2019 to Sep 2020. Methodology: One hundred forty patients were selected according to SLE ACR (American College of Rheumatology) criteria. Detailed history and examination, including dermatological examination, were done, and blood samples were taken for baseline investigations and SLE-related autoimmune profile. Statistical analysis was done using SPSS 23 to determine the correlation between skin, central nervous system and renal involvement. Results: In our study, among the lupus-specific lesions, photosensitivity was most frequent 119 (85%) finding followed by oral ulcers 114 (81.4%), alopecia 112 (80%) and malar rash 81 (57.9%). Among the immunological profile, antinuclear antibody (ANA) was the most frequent 116 (82.9%) finding, followed by anti-double stranded antibody 71 (51.7%). Hypocomplementemia and anti-Sm antibody was significantly associated with lupus nephritis (p-value <0.05). There was no correlation between skin and neuropsychiatric involvement and skin and nephritis. Conclusion: This study depicts the clinical immune profile of SLE patients in Pakistan. In our patients, autoimmune profile and complement levels could predict renal involvement.

show abstract

“…One potential mechanism of thrombocytopenia was due to increased activation and destruction of platelets by aPLs ( 23 ). Activation of the complement pathway and coagulation system by aPLs was also hypothesized to be the underlying cause of hemolytic anemia ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and diagnostic value of non-criteria antiphospholipid antibodies for antiphospholipid syndrome in Chinese patients

Bai

Meng

et al. 2023

Front. Immunol.

View full text Add to dashboard Cite

BackgroundThe presence of antiphospholipid antibodies (aPLs) plays a pivotal role in the pathogenesis of antiphospholipid antibody syndrome (APS). This study aimed to examine the diagnostic value of a set of non−criteria aPLs and their relevance with APS-related criteria and extra-criteria manifestations.MethodsFrom a prospectively constructed database, consecutive APS patients consisting of 114 primary APS (PAPS group), 54 with APS secondary to SLE (SAPS group), 9 seronegative APS (SNAPS), as well as 209 patients with systemic lupus erythematosus (SLE) and 88 healthy controls were included in this study. Levels of criteria aPLs, baseline information, and APS-related criteria and extra-criteria features were extracted from the database. Serum levels of non-criteria aPLs including aPC IgG/IgM, aPI IgG/IgM, aPE IgG/IgM/IgA, aPG IgG/IgM/IgA, anti-phosphatidic acid (aPA) IgG/IgM, aSM IgG/IgM, and aPS/PT IgG/IgM were analyzed with AESKULISA® ELISA Test Kits.ResultsThe addition of aPC IgG/M, aPI IgG/M, aPE IgG/M/A, aSM IgG/M, and aPA IgG/M to aCL or aβ2GPI IgG/M could significantly increase diagnostic sensitivity and accuracy. A significant difference between PAPS or SAPS and HC was presented in all non-criteria aPLs except for aSM IgM and aPG IgA. Eight out of nine SNAPS patients were positive for at least 1 aPL. Pregnancy morbidity was associated with aSM IgM (r = 0.22) and aSM IgG (r = 0.15). Pre-eclampsia or premature birth was associated with aSM IgG (r = 0.16), aPI IgG (r = 0.22), aPC IgG (r = 0.16), and aPG IgG (r = 0.18). Stroke was associated with aPI IgG (r = 0.2). The clinical association was also observed in DVT with aPS/PT IgG (r = 0.17). Valve lesion was positively associated with aSM IgM (Fisher test p = 0.039), APS nephropathy was associated with aPC IgG (OR 3.797), and livedo reticularis was associated with aPE IgM (OR 15.391).ConclusionAdditional detection of non-criteria aPLs including aPC IgG/M, aPE IgG/M/A, aPI IgG/M, aSM IgG/M, and aPA IgG/M could assist in APS diagnosis. The positivity of certain aPLs was statistically associated with both criteria and extra-criteria APS clinical manifestations.

show abstract

Antiphospholipid Antibodies and Autoimmune Haemolytic Anaemia: A Systematic Review and Meta-Analysis

Cited by 16 publications

References 85 publications

Thrombotic Complications in Patients with Immune-Mediated Hemolysis

Thrombotic Complications in Patients with Immune-Mediated Hemolysis

Clinico-Immunological Profile of Systemic Lupus Erythematosus Patients in Pakistan and Their Correlation

Prevalence and diagnostic value of non-criteria antiphospholipid antibodies for antiphospholipid syndrome in Chinese patients

Contact Info

Product

Resources

About