Antiphospholipid Syndrome

Bermas, Bonnie L.

doi:10.1007/978-1-4614-1189-5_15

Cited by 2 publications

(3 citation statements)

References 38 publications

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“…- aCL antibody of IgG and/or IgM isotype in serum or plasma, in moderate or high titer (>40 units GPL or MPL or >99 th percentile), measured by a standardized ELISA. - Antibodies to ß 2 -glycoprotein I (anti-β 2 GPI) of IgG and/or IgM isotype in serum or plasma (at a titer >99 th percentile), measured by a standardized ELISA [ 50 , 51 ].…”

Section: Managementmentioning

confidence: 99%

Hematological Disorders in Patients with Systemic Lupus Erythematosus

Bashal¹

2013

TORJ

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This article is a review of different management strategies for the hematological manifestations of systemic lupus erythematosus (SLE), the strategies include immunosuppressive drugs, some noval therapies and B-cell depletion for refractory thrombocytopenia in patients with SLE and in antiphospholipid antibody syndrome associated with SLE. The researcher questions the validity of the current classic treatment modes and the article explores the relationships between SLE hematological manifestations and the level of morbidity and mortality burden and focuses on the pathophysiology, diagnostic approaches and management strategies of these manifestations.The researcher focuses on hematological abnormalities because they are the commonest among most manifestations in SLE seen in Anemia, leucopenias and thrombocytopenia. They commonly result from an immune mediated bone marrow failure, excessive peripheral cells destruction or certain drugs and infections. There is also an association between anti-phospholipid antibody syndrome (APS) and SLE referred to as secondary APS or SLE-APS. Furthermore, it was recently found that mycophenolatemofetil acts as corticosteroids and as cyclophosphamide sparing agent. Although there is no specific therapy for cytopenias in SLE, corticosteroids remain the mainstay in the treatment of these patients along with less used other conventional treatment options such as azathioprine, cyclophosphamide and human normal immunoglobulin. There are other novel therapies such as thrombopoietin receptor agonists in thrombocytopenia and the use of autologous hematopoitic stem cells transplantation in refractory SLE-APS that are under review. Some of these therapies include thrombopoietin receptor agonists in thrombocytopenia and the use of autologous hematopoitic stem cells transplantation in refractory SLE-APS.The study concludes that treatment of hematological abnormalities is challenging because the treatment itself can cause undue complications sometimes such as granulocytosis due to infection or the use of high doses of steroids and may occur during acute exacerbations of SLE. It is important to take these factors into consideration for disease therapy and management.Publication Abstract:This article is a review of different management strategies for the hematological manifestations of systemic lupus erythematosus (SLE). The strategies include immunosuppressive drugs, some novel therapies and B-cell depletion for refractory thrombocytopenia in patients with SLE and in anti-phospholipid antibody syndrome associated with SLE. The researcher questions the validity of the current classic treatment modes and the article explores the relationships between SLE hematological manifestations and the level of morbidity and mortality burden while it focuses on the pathophysiology, diagnostic approaches and management strategies. The study concludes that hematological abnormalities are the commonest among most manifestations in SLE, and that their treatment is challenging because the treatment itself can cau...

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Section: Managementmentioning

confidence: 99%

Hematological Disorders in Patients with Systemic Lupus Erythematosus

Bashal¹

2013

TORJ

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“…It was found that patients with APS associated with SLE more frequently exhibited thrombocytopenia than patients with primary APS (43 versus 21%) [ 2 ]. Thrombocytopenia does not preclude the occurrence of thrombotic complication of APS [ 1 ]. The treatment of thrombocytopenia is the same for idiopathic thrombocytopenic purpura [ 15 ], which is corticosteroids and other medications used for steroid-resistant thrombocytopenia, such as IVIG and danazol.…”

Section: Discussionmentioning

confidence: 99%

“…However, the understanding of the potential roles played by such antibodies in APS is incomplete, and assays for these antibodies are not a part of the standard evaluation when APS is suspected. Antibodies to prothrombin are associated with bleeding and thrombosis [ 1 ]. Thrombosis is the most common clinical manifestation of APS, and the recurrence of thrombotic events is common as well.…”

Section: Introductionmentioning

confidence: 99%

Bleeding and thrombosis in a patient with primary antiphospholipid syndrome using norethisterone: a case report

2015

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IntroductionAntiphospholipid syndrome is known to be associated with the occurrence of venous and/or arterial thrombosis. There are several factors that might trigger the risk of thrombosis in antiphospholipid syndrome, including drugs, however bleeding is rare. Only a few cases of antiphospholipid syndrome have reported simultaneous bleeding and thrombosis, and only a few of these cases have reported thrombosis induced by norethisterone when used by patients with an underlying risk factor for thromboembolism.Case presentationWe report the case of a 35-year-old Saudi woman diagnosed with antiphospholipid syndrome with a history of several spontaneous miscarriages and two previous lower limb deep vein thromboses. She had used norethisterone to postpone her menstruation and presented to our institution with severe menorrhagia. During admission, she developed thrombocytopenia, and at the same time she was found to have extensive inferior vena cava and bilateral common iliac thrombosis.ConclusionsThis case report is of interest to rheumatologists, hematologists and radiologists because we have found that the presence of bleeding and thrombocytopenia do not preclude the concomitant occurrence of thrombotic complications of antiphospholipid syndrome. Norethisterone is normally safe to take, but it is not suitable for patients with an increased risk of deep vein thrombosis. Also, the simultaneous management of thrombosis and heavy vaginal bleeding is a challenge for clinicians since there are no evidence-based guidelines regarding the management of these patients.

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Antiphospholipid Syndrome

Cited by 2 publications

References 38 publications

Hematological Disorders in Patients with Systemic Lupus Erythematosus

Hematological Disorders in Patients with Systemic Lupus Erythematosus

Bleeding and thrombosis in a patient with primary antiphospholipid syndrome using norethisterone: a case report

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