Gastrointestinal: Ischemic gastrointestinal manifestations in a young adult: Implicating a rare initial presentation of antiphospholipid syndrome

Senatore, Frank; McDonald, Kymberly

doi:10.1111/jgh.13390

Cited by 6 publications

(3 citation statements)

References 4 publications

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“…Arterial thrombosis of intra-abdominal organs occurs more frequently in APS (up to 6%) compared with intra-abdominal venous thrombosis [ 8 , 30 , 36 ]. Mesenteric artery thrombosis is present in ∼0.6% to 2% of APS patients [ 8 , 30 , 32 , 34 ], either in the context of catastrophic APS [ 12 , 66 ] or as isolated cases [ 120 , 121 ], and even as the first APS presentation [ 121 ]. It can lead to small and/or large-bowel perforation that warrants emergency management [ 122 ].…”

Section: Macrovascular Manifestations In Apsmentioning

confidence: 99%

“…Chronic abdominal angina has also been described in APS [ 123 ]. Splenic infarcts may occur in ∼1% of APS patients [ 8 , 30 , 83 ] and often co-exists with other abdominal organs ischaemia [ 121 , 123 ]. Interestingly, APS has been recognized as one of the major causes of splenic infarction in the general population [ 124 ].…”

Section: Macrovascular Manifestations In Apsmentioning

confidence: 99%

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Epidemiology of antiphospholipid syndrome: macro- and microvascular manifestations

Gaspar,

Sciascia,

Tektonidou

2024

Rheumatology

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Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombotic and non-thrombotic macro- and microvascular manifestations and pregnancy complications in the setting of persistent antiphospholipid antibodies (aPL), namely anticardiolipin antibodies, anti-β2 glycoprotein-I antibodies and lupus anticoagulant. Four decades after its first description, APS prevalence and incidence are still not completely understood due to the limited number of well-designed, population-based multi-ethnic studies. Furthermore, despite decades of efforts to standardise aPL immunoassays, considerable intraassay and interlaboratory variances in aPL measures still exist. Large multicentre APS cohorts have shown a 10-year survival of ∼91% and the presence of catastrophic APS occurs in about 1% of the entire population, associated with a 50% mortality rate. Clinically, any organ can be affected in the context of large, medium or small vessel (artery and/or vein) thrombosis. Macrovascular thrombosis is the hallmark of the disease and veins are more frequently affected than arteries. Deep vein thrombosis/pulmonary embolism thromboembolic disease is the most common APS manifestation, while stroke and transient ischaemic attack are the most frequent arterial thrombosis events. Myocardial infarction can also occur and contributes to increased mortality in APS. A minority of patients present with thrombosis affecting the intraabdominal organs, including the liver, spleen, small and large bowel, and the kidneys. Microvascular thrombosis, including APS nephropathy, chronic skin ulcers and livedoid vasculopathy represent a diagnostic challenge requiring histologic confirmation. In this narrative review we summarize the available evidence on APS epidemiology, focusing on the description of the prevalence of macro- and microvascular manifestations of the disease.

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Section: Macrovascular Manifestations In Apsmentioning

confidence: 99%

Section: Macrovascular Manifestations In Apsmentioning

confidence: 99%

Epidemiology of antiphospholipid syndrome: macro- and microvascular manifestations

Gaspar,

Sciascia,

Tektonidou

2024

Rheumatology

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“…A number of APS patients have been reported with intestinal infarction from mesenteric thrombosis [32][33][34][35]. Intestinal venous or arterial thrombosis and infarction appear to be prominent features of APS associated small intestinal involvement.…”

Section: Intestinal Manifestationsmentioning

confidence: 99%

The digestive system involvement of antiphospholipid syndrome: pathophysiology, clinical characteristics, and treatment strategies

Zhang

Han

et al. 2021

Annals of Medicine

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Antiphospholipid syndrome (APS) is an autoimmune disease mainly characterised by vascular thrombosis and pregnancy morbidity. APS has broad spectrum of clinical manifestations. The digestive system involvement of antiphospholipid syndrome is a critical but under-recognised condition. Digestive system involvement may be the result of direct (autoimmune-mediated) or indirect (thrombotic) mechanisms. Liver is the most commonly involved organ, followed by intestines, oesophagus, stomach, pancreas and spleen. This review describes possible digestive system manifestations in APS patients, and illustrates the epidemiology and possible pathophysiology of APS. The role of different treatment strategies in the management of digestive system manifestations of APS were also discussed. Key messages Antiphospholipid syndrome is a multi-organ, multi-system disease and its clinical manifestation spectrum is gradually expanding. Since the first diagnosis of APS, the clinical manifestations of digestive system have been reported successively. This narrative review describes the major digestive system manifestations of APS and illustrates the epidemiology, pathophysiology and the role of therapeutic strategies of these patients.

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Abdominal pain in patient with antiphospholipid syndrome—the role of MDCT angiography on visceral blood vessels

et al. 2017

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Antiphospholipid syndrome (APS) is an autoimmune disease defined by accelerated atherosclerosis, arterial and venous thrombosis, fetal loss, and the presence of antiphospholipid antibodies (aPL) in the serum and which leads to the occurrence of various vascular events. Nonspecific abdominal pain can be one of the symptoms due to changes on visceral blood vessels. The goal of our work is to show the results we obtained in multidetector computed tomography (MDCT) angiography examination of visceral arteries, comparing patients with primary antiphospholipid syndrome (PAPS) and secondary antiphospholipid syndrome (SAPS) with control group. In this study, we analyzed 50 patients with primary PAPS and 50 patients, with secondary SAPS. The results were compared to 50 patients in the control group. The groups were compared in terms of age, gender, and the most common risk factors except for the lipid status, since controls had significantly higher levels of cholesterol and triglycerides. The study was conducted on 64-MDCT, on which we analyzed quantitative and morphological characteristics of the blood vessel lesions. Patients from the control group had statistically significant elevation of cholesterol and triglyceride levels compared to the patients with SAPS and PAPS (p < 0.001 and p < 0.05). The results showed that the frequency of changes is statistically (p < 0.05 and p < 0.001) more common in patients with PAPS and SAPS than in the control group. Statistically significant difference between the groups was found in superior and inferior mesentery arteries. Analyzing the number of lesions, there was statistically high difference between the patients with one and two lesions than in patients with four or more lesions (p < 0.001), lower difference compared to the patients with three lesions (p < 0.01), while there was low, but yet statistically important difference between the patients with three lesions and those with five or more blood vessel lesions (p < 0.05). Analyzing percentage of diameter stenosis, we established that the lesions in the groups of 0-30% diameter stenosis (DS) and 30-50% DS in patients with PAPS (n = 42) and SAPS (n = 44) are more common than in the control group (n = 18, p < 0.05). Analyzing the qualitative characteristics of plaques, we established significantly higher frequency of soft tissue and mixed lesions than calcified ones in patients with PAPS and SAPS (p < 0.001; p < 0.05). Our study showed that the subclinical manifestation of the changes on visceral arteries is more common in patients with APS. Patients with abdominal pain were those with two or more lesions, and according to our results, majority had PAPS. Because of its safety and accuracy, the method of choice is MDCT angiography in monitoring the progression of disease.

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Gastrointestinal: Ischemic gastrointestinal manifestations in a young adult: Implicating a rare initial presentation of antiphospholipid syndrome

Cited by 6 publications

References 4 publications

Epidemiology of antiphospholipid syndrome: macro- and microvascular manifestations

Epidemiology of antiphospholipid syndrome: macro- and microvascular manifestations

The digestive system involvement of antiphospholipid syndrome: pathophysiology, clinical characteristics, and treatment strategies

Abdominal pain in patient with antiphospholipid syndrome—the role of MDCT angiography on visceral blood vessels

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