Hospital based prospective longitudinal clinical and immunologic study of 179 patients of primary anti-phospholipid syndrome

Singh, Nand Kumar; Behera, Debasis; Agrawal, Ankit; Singh, Manish Pal; Kumar, Vineet; Godhra, Manoj; Gupta, Anurag; Yadav, Dhananjay; Singh, Usha; Pandey, Lakshmi Kant; Matah, Manjari

doi:10.1111/1756-185x.12150

Cited by 5 publications

(7 citation statements)

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“…A previous study reported that patients with APS have approximately a 22–75% chance of fetal loss . Similarly, a prospective analysis of 179 patients of primary anti‐phospholipid syndrome reported that 72% patients had fetal loss, of which late fetal loss was the most common (54.18%) . APS has high prevalence of fetal loss.…”

Section: Discussionmentioning

confidence: 96%

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The association between antiphospholipid antibodies and late fetal loss: A systematic review and meta‐analysis

Chen

Duan

et al. 2019

Acta Obstet Gynecol Scand

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Introduction Antiphospholipid syndrome is a chronic autoimmune disease with a high prevalence in females. Published data have identified that antiphospholipid antibodies (APLA) of antiphospholipid syndrome are risk factors for poor pregnancy outcomes, such as recurrent spontaneous abortion, intrauterine growth restriction and preeclampsia. However, the association between APLA and late fetal loss is not fully understood and remains controversial. The aim of this study is to identify and analyze the recent publications to better understand the association between APLA and late fetal loss. Material and methods The literature was searched on 31 January 2019 using Ovid, Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) to evaluate the association between APLA and late fetal loss, with articles published before January 2019, according to the PRISMA statement. Without imposing regional restrictions, referenced articles were selected. Quality assessment was conducted independently by two reviewers, based on the Newcastle‐Ottawa scale. For the meta‐analysis, we used odds ratios (random effects model). The between‐study heterogeneity was assessed by Q test. Publication bias was assessed by funnel plots. Results Nineteen studies (with 10 265 cases) were included in the final analysis. The odds ratio (OR) for the late fetal loss with lupus anticoagulant was 5.02 (95% confidence interval [CI] 2.14‐7.89). Seven included studies reported that lupus anticoagulant had a statistically significant association with late fetal loss. The results did not show a statistically significant association between anticardiolipin antibodies and late fetal loss. The pooled odds ratio for the association of anticardiolipin antibodies with late fetal loss was 3.47 (95% CI 0.68‐6.26). However, we did find the relation between anticardiolipin antibodies and late fetal loss among cohort studies (OR 2.27, 95% CI 1.20‐3.44). Anti‐beta2 glycoprotein 1 antibodies (β2GP1) showed a significant association with late fetal loss (OR 3.13, 95% CI 0.75‐5.50). Conclusions Lupus anticoagulant is strongly associated with late fetal loss in antiphospholipid syndrome patients. However, the association between anticardiolipin antibodies and late fetal loss is inconsistent. There are currently insufficient data to support a significant relation between β2GP1 and late fetal loss.

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Section: Discussionmentioning

confidence: 96%

“…29 Similarly, a prospective analysis of 179 patients of primary anti-phospholipid syndrome reported that 72% patients had fetal loss, of which late fetal loss was the most common (54.18%). 30 APS has high prevalence of fetal loss. In contrast, there was a high prevalence of women with late fetal loss who were APLA-positive.…”

Section: Discussionmentioning

confidence: 99%

The association between antiphospholipid antibodies and late fetal loss: A systematic review and meta‐analysis

Chen

Duan

et al. 2019

Acta Obstet Gynecol Scand

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“…In the current study, we observed three or more consecutive unexplained abortions in less than 10 weeks of gestation as the most common obstetric complication, being present in around 60% of the patients. However, Singh et al,[ 18 ] in a study from India, demonstrated recurrent early fetal loss only in one-fifth of their patients. Similarly, studies from Thailand and Japan demonstrated that early fetal loss comprised of around 13% of their study population, which is much less than our finding.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, various clinical features between different ethnicities have been demonstrated in existing studies of APS in Asian population. [ 16 - 18 ] In this study, we aimed to report a 10-year retrospective analysis on the clinical presentations, patterns of laboratory parameters, treatment options, and outcomes of APS patients in a cohort of Pakistani population.…”

Section: Introductionmentioning

confidence: 99%

A retrospective review of antiphospholipid syndrome from a South Asian country

et al. 2021

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Objectives: This study aims to investigate clinical presentations, antiphospholipid antibody patterns and their levels, therapeutic regimens, and outcomes in patients with antiphospholipid syndrome (APS) admitted to a tertiary care hospital of a South Asian country. Patients and methods: Between January 2009 and December 2019, a total of 216 patients with APS (8 males, 208 females; median age: 35.7±6.9 years; range, 20 to 76 years) who either fulfilled the modified Sydney criteria or those who satisfied only clinical criteria along with positive antiphospholipid antibody on at least one occasion (probable APS) were retrospectively analyzed. Results: The majority of the patients (n=183, 84.7%) had obstetric complications, followed by venous thrombosis in 23 (10.8%) patients. Recurrent early abortions in 126 (58.6%) and deep venous thrombosis in 16 (7.4%) patients were the most prevalent obstetrical and venous events, respectively, whereas limb gangrene in seven (3.3%) and ischemic stroke in seven (3.3%) were the most common arterial events. A total of 190 (88%) patients had primary APS, while 26 (12%) had secondary APS. Systemic lupus erythematosus was the frequent association with secondary APS found in 19 (73%) patients. Immunoglobulin M (IgM) anticardiolipin antibody was present in 173 (65.0%) patients, being the most commonly reported antibody. Probable catastrophic APS was found in four (1.9%) patients. Majority of the patients (n=190, 87.9%) were treated with a combination of acetylsalicylic acid and low-molecular-weight heparin. Single mortality was observed in our study population due to complications related to catastrophic APS. Conclusion: Antiphospholipid syndrome has a wide range of thrombotic and obstetrical manifestations with important variations in different regions of the world. There is a significant morbidity and mortality related to APS, despite treatment with anticoagulation and; therefore, describing prognostic markers and optimal therapeutic interventions is pivotal to prevent complications.

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“…Antiphospholipid syndrome) may lead to a variety of clinical manifestations due to venous and arterial thrombosis. It is also an important cause of early and late pregnancydeaths and morbidities [7].…”

Section: Case 02mentioning

confidence: 99%

Medicolegal aspects of Maternal Deaths due to Pulmonary Thromboembolism

Vidanapathirana

Gunethilake

2015

Sri Lanka J Forensic Med, Sci & Law

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Hospital based prospective longitudinal clinical and immunologic study of 179 patients of primary anti-phospholipid syndrome

Abstract: Primary APS may lead to a variety of clinical manifestations due to venous and/or arterial thrombosis, which at times may be lethal. It is also an important cause of early and late pregnancy loss(es) and other pregnancy morbidities.

Cited by 5 publications

References 19 publications

The association between antiphospholipid antibodies and late fetal loss: A systematic review and meta‐analysis

The association between antiphospholipid antibodies and late fetal loss: A systematic review and meta‐analysis

A retrospective review of antiphospholipid syndrome from a South Asian country

Medicolegal aspects of Maternal Deaths due to Pulmonary Thromboembolism

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