Evolution of Antiphospholipid Antibody Syndrome

Baviskar, Rutuja R; Amonkar, Gayathri; Chaudhary, Vinod A.; Meenakshi, B; Mohite, Shailesh; Puranik, Gururaj

doi:10.1097/paf.0b013e31822ad23e

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…Several case reports with pathology, in persons of any age, describe aPL syndrome associated with widespread (multi-organ) microvascular thrombotic injury, and in the brain specifically, with brain infarcts or hemorrhages, and no evidence for inflammation. 6,9,21,22 Few case series are available, almost all with less than 10 subjects with aPL and brain pathology data available. These series describe thrombo-occlusive disease in the brain, small but also some large infarcts, and no inflammation or vasculitis.…”

Section: Discussionmentioning

confidence: 99%

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Relation of Antiphospholipid Antibodies to Postmortem Brain Infarcts in Older People

et al. 2015

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Background-There are few data on the relationship of antiphospholipid antibodies (aPLs) to pathologically proven brain infarcts. We tested the hypothesis that aPLs are associated with a higher odds of brain infarcts among older, communitydwelling individuals who came to autopsy. Methods and Results-Specimens and clinical and pathological data were derived from 607 deceased subjects (mean age at death, 89 years; 66% women) who were participating in 1 of 2 cohort studies of aging (Rush Memory and Aging Project and Religious Orders Study) and had agreed to brain autopsy. Brain infarcts were identified on gross and microscopic examinations, and severity of cerebral vessel disease (atherosclerosis, arteriolosclerosis) was graded. Four clinically used aPLs were measured longitudinally: 3 in serum (anticardiolipin antibodies, β 2-glycoprotein I, and anti-phosphatidylserine) and 1 in plasma (lupus anticoagulant). A quarter of subjects (142 of 607, 23%) had at least 1 aPL present at baseline (median time interval from baseline to death, 4.6 years), and three quarters of these subjects had persistently positive measures over time. In a logistic regression analysis, baseline aPL positivity did not increase the odds of brain infarcts (odds ratio=1.08; 95% confidence interval, 0.74-1.58; P=0.19) or of gross or microscopic infarcts separately. Findings were essentially unchanged when considering number of baseline aPLs, aPLs proximate to death, and persistence of aPLs. Associations did not differ among subjects with increased severity of vessel disease. Conclusion-Overall, we did not find evidence that aPLs increase the odds of pathological brain infarcts in older people. (Circulation. 2015;131:182-189.

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Section: Discussionmentioning

confidence: 99%

“…Indeed, only a small number of case reports and case series of select autopsied groups are published, and these report a range of pathologies including brain infarcts and other vascular processes. 6–9 …”

mentioning

confidence: 99%

Relation of Antiphospholipid Antibodies to Postmortem Brain Infarcts in Older People

et al. 2015

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The characteristics of clinical laboratory indicators in anticardiolipin antibody positive cerebral infarction patients

Chen

Fang

Zheng

et al. 2022

International Immunopharmacology

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Risk factors for cerebral infarction and cerebrovascular stenosis in antiphospholipid antibody-positive patients: A retrospective single-center study with propensity score matching analysis

Ha,

Kim,

Huh

et al. 2024

Medicine

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Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by the presence of antiphospholipid antibodies (aPLA), such as anticardiolipin (aCL), anti-β2-glycoprotein I (aβ2GPI), or lupus anticoagulant (LA). Although cerebrovascular events are commonly associated with APS, comprehensive studies on risk factors for cerebral infarction in aPLA-positive patients remain sparse. In this retrospective single-center study, data from 9844 patients tested for aPLA between January 2017 and March 2023 were analyzed. A total of 647 aPLA-positive patients were included, with assessments of various factors including age, gender, hypertension, diabetes, dyslipidemia, smoking history, and cardiac disease. Propensity score matching was employed to create 2 matched groups of 202 patients each, comparing those with and without cerebral infarction. Logistic regression analyses were conducted to identify risk factors for cerebral infarction and progression of cerebrovascular stenosis. The mean age of the study cohort was 65.8 years, with 60% being male. LA was positive in 95.2% of the cases, aCL in 8.8%, and aβ2GPI in 5.3%. High-risk aPLA profiles were identified in 7.1% of the cases. In the cerebral infarction group, both smoking history and aCL positivity were significantly associated with an increased risk (OR = 1.543; 95% CI: 1.020–2.334; P = .040 and OR = 3.043; 95% CI: 1.426–6.491; P = .040, respectively). Male gender and posterior circulation involvement were significant risk factors for exacerbation of cerebrovascular stenosis (OR = 3.73; 95% CI: 1.16–16.69; P = .046 and OR = 5.41; 95% CI: 1.80–16.05; P = .002, respectively). Smoking history and aCL positivity are prominent risk factors for cerebral infarction in aPLA-positive patients, while male gender and involvement of the posterior circulation emerge as significant risk factors for the progression of cerebrovascular stenosis. Further comprehensive prospective studies are necessary to deepen understanding of aPLA-related cerebrovascular diseases.

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Evolution of Antiphospholipid Antibody Syndrome

Cited by 3 publications

References 5 publications

Relation of Antiphospholipid Antibodies to Postmortem Brain Infarcts in Older People

Relation of Antiphospholipid Antibodies to Postmortem Brain Infarcts in Older People

The characteristics of clinical laboratory indicators in anticardiolipin antibody positive cerebral infarction patients

Risk factors for cerebral infarction and cerebrovascular stenosis in antiphospholipid antibody-positive patients: A retrospective single-center study with propensity score matching analysis

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