Antiphospholipid-Thrombosis Syndromes

Abstract

The user has requested enhancement of the downloaded file.

Antiphospholipid thrombosis syndromes

“…The frequency of hemorrhage resulting from the LA is clearly less than 1%; however, it is important to recognize conditions that may predispose patients with lupus harboring an LA to hemorrhage [21,22]. Twenty-five percent of patients with systemic lupus have concomitant prothrombin deficiency, and more than 40% may have thrombocytopenia; these accompanying defects are noted particularly in those with secondary LA-thrombosis syndromes [21,23].…”

“…Of greater clinical significance, patients with the LA are at increased risk for thromboembolic disease, most commonly deep vein thrombosis, pulmonary emboli, and thrombosis of other large vessels [24,25]. Thromboembolism occurs in approximately 10% of patients with systemic lupus; however, in patients with systemic lupus and the LA, thromboembolism occurs in up to 50% of patients.…”

“…In patients harboring a primary LA, the LA is estimated to account for approximately 6% to 8% of thrombosis in otherwise healthy individuals. There also have been associations with primary LA syndrome and recurrent miscarriage, neuropsychiatric disorders, renal vascular thrombosis, thrombosis of dermal vessels, and thrombocytopenia [20,23,26,27].…”

“…Of interest, biologic false-positive test results for syphilis are seen in up to 40% of patients with systemic lupus; the number increases to 90% in patients with systemic lupus plus the LA [22,25,31]. An abnormality often (theoretically) exists in the phospholipiddependent coagulation reactions, including the prothrombin time, the activated partial thromboplastin time (aPTT), and the Russell's viper venom time because the LA is not directed against a specific factor but to phospholipids.…”

Antiphospholipid antibody syndrome presenting with disseminated bleeding and spinal subdural hemorrhage

“…2 APS can occur as an isolated diagnosis, known as primary antiphospholipid antibody syndrome (PAPS) or can be associated with systemic lupus erythematosus (SLE) or other rheumatic diseases when it is known as secondary APS. 3 Even though APS is a condition commonly associated with arterial or venous thrombosis, very rarely it can lead on to hemorrhage also. 4 This occurs when patients with APS develop antibodies directed against prothrombin leading on to clinically significant hypoprothrombinemia leading to hemorrhage.…”