Research Article
BibTex RIS Cite

Year 2021, Volume: 74 Issue: 1, 52 - 59, 30.04.2021
https://doi.org/10.4274/atfm.galenos.2020.18189

Abstract

Project Number

-

References

  • 1. Miyakis S, Lockshin MD, Atsumi T, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4:295-306.
  • 2. Belizna C, Stojanovich L, Cohen-Tervaert JW, et al. Primary antiphospholipid syndrome and antiphospholipid syndrome associated to systemic lupus: Are they different entities? Autoimmun Rev. 2018;17:739-745.
  • 3. Swaak AJ, van de Brink H, Smeenk RJ, et al. Incomplete lupus erythematosus: results of a multicentre study under the supervision of the EULAR Standing Committee on International Clinical Studies Including Therapeutic Trials (ESCISIT). Rheumatology (Oxford). 2001;40:89-94.
  • 4. Asherson RA, Cervera R, de Groot PG, et al. Catastrophic antiphospholipid syndrome: international consensus statement on classification criteria and treatment guidelines. Lupus. 2003;12:530-534.
  • 5. Asherson RA, Cervera R. ‘Primary’, ‘secondary’ and other variants of the antiphospholipid syndrome. Lupus. 1994;3:293-298.
  • 6. Grika EP, Ziakas PD, Zintzaras E, et al. Morbidity, mortality, and organ damage in patients with antiphospholipid syndrome. J Rheumatol. 2012;39:516-523.
  • 7. Cervera R, Piette JC, Font J, et al. Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients. Arthritis Rheum. 2002;46:1019-1027.
  • 8. Alijotas-Reig J, Esteve-Valverde E, Ferrer-Oliveras R, et al. The European Registry on Obstetric Antiphospholipid Syndrome (EUROAPS): A survey of 1000 consecutive cases. Autoimmun Rev. 2019;18:406-414.
  • 9. Cervera R, Khamashta MA, Shoenfeld Y, et al. Morbidity and mortality in the antiphospholipid syndrome during a 5-year period: a multicentre prospective study of 1000 patients. Ann Rheum Dis. 2009;68:1428-1432.
  • 10. Sanna G, D’Cruz D, Cuadrado MJ. Cerebral manifestations in the antiphospholipid (Hughes) syndrome. Rheum Dis Clin North Am. 2006;32:465-490.
  • 11. Hughes GR. Migraine, memory loss, and “multiple sclerosis”. Neurological features of the antiphospholipid (Hughes’) syndrome. Postgrad Med J. 2003;79:81-83.
  • 12. Ricarte IF, Dutra LA, Abrantes FF, et al. Neurologic manifestations of antiphospholipid syndrome. Lupus. 2018;27:1404-1414.
  • 13. Cervera R, Boffa MC, Khamashta MA, et al. The Euro-Phospholipid project: epidemiology of the antiphospholipid syndrome in Europe. Lupus. 2009;18:889-893.
  • 14. de Carvalho JF, Pasoto SG, Appenzeller S. Seizures in primary antiphospholipid syndrome: the relevance of smoking to stroke. Clin Dev Immunol. 2012;2012:981519.
  • 15. Shoenfeld Y, Lev S, Blatt I, et al. Features associated with epilepsy in the antiphospholipid syndrome. J Rheumatol. 2004;31:1344-1348.
  • 16. Rovaris M, Pedroso C, Filippi M. Neuroimaging techniques in the diagnostic work-up of patients with the antiphospholipid syndrome. Curr Rheumatol Rep. 2001;3:301-306.
  • 17. Ramos-Casals M, Campoamor MT, Chamorro A, et al. Hypocomplementemia in systemic lupus erythematosus and primary antiphospholipid syndrome: prevalence and clinical significance in 667 patients. Lupus. 2004;13:777-783.
  • 18. Carbone J, Orera M, Rodríguez-Mahou M, et al. Immunological abnormalities in primary APS evolving into SLE: 6 years follow-up in women with repeated pregnancy loss. Lupus. 1999;8:274-278.
  • 19. Núñez-Álvarez CA, Hernández-Molina G, Bermúdez-Bermejo P, et al. Prevalence and associations of anti-phosphatidylserine/prothrombin antibodies with clinical phenotypes in patients with primary antiphospholipid syndrome: aPS/PT antibodies in primary antiphospholipid syndrome. Thromb Res. 2019;174:141-147.
  • 20. Saccone G, Berghella V, Maruotti GM, et al. Antiphospholipid antibody profile based obstetric outcomes of primary antiphospholipid syndrome: the PREGNANTS study. Am J Obstet Gynecol. 2017;216:525.
  • 21. Vianna JL, Khamashta MA, Ordi-Ros J, et al. Comparison of the primary and secondary antiphospholipid syndrome: a European Multicenter Study of 114 patients. Am J Med. 1994;96:3-9.
  • 22. Abu-Zeinah G, Oromendia C, DeSancho MT. Thrombotic risk factors in patients with antiphospholipid syndrome: a single center experience. J Thromb Thrombolysis. 2019;48:233-239.
  • 23. Galli M, Luciani D, Bertolini G, et al. Lupus anticoagulants are stronger risk factors for thrombosis than anticardiolipin antibodies in the antiphospholipid syndrome: a systematic review of the literature. Blood. 2003;101:1827-1832.
  • 24. Pengo V, Ruffatti A, Legnani C, et al. Clinical course of high-risk patients diagnosed with antiphospholipid syndrome. J Thromb Haemost. 2010;8:237-242.
  • 25. da Silva Saraiva S, Custódio IF, de Moraes Mazetto B, et al. Recurrent thrombosis in antiphospholipid syndrome may be associated with cardiovascular risk factors and inflammatory response. Thromb Res. 2015;136:1174-1178.
  • 26. Mary-Carmen Amigo MAK. Antiphospholipid syndrome: pathogenesis, diagnosis, and management. In: Marc C. Hochberg EMG, Alan J. Silman,, Josef S. Smolen MEW, Michael H. Weisman., editors. Rheumatology (Hochberg). 7th ed. Philadelphia, PA: Elsevier.; 2019. s. 1221-1229.
  • 27. Radin M, Sciascia S, Erkan D, et al. The adjusted global antiphospholipid syndrome score (aGAPSS) and the risk of recurrent thrombosis: Results from the APS ACTION cohort. Semin Arthritis Rheum. 2019;49:464-468.
  • 28. Oku K, Atsumi T, Bohgaki M, et al. Complement activation in patients with primary antiphospholipid syndrome. Ann Rheum Dis. 2009;68:1030-1035.
  • 29. Al-khayat Z, Waheda NE, Shaker NF. Complement C3 and C4 Levels in Recurrent Aborting Women with or without Antiphospholipid and Anticardiolipin Autoantibodies. Ibnosina J Med BS. 2014;6:143-148.
  • 30. Tabacco S, Giannini A, Garufi C, et al. Complementemia in pregnancies with antiphospholipid syndrome. Lupus. 2019;28:1503-1509 31. Crowther MA, Ginsberg JS, Julian J, et al. A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome. N Engl J Med. 2003;349:1133-1138.
  • 32. Finazzi G, Marchioli R, Brancaccio V, et al. A randomized clinical trial of high-intensity warfarin vs. conventional antithrombotic therapy for the prevention of recurrent thrombosis in patients with the antiphospholipid syndrome (WAPS). J Thromb Haemost. 2005;3:848-853.

Antifosfolipid Sendromlu Hastaların Klinik Özellikleri ve Tekrarlayan Trombozu Olan Hastaların Farklılıkları, Tek Merkezli Retrospektif Bir Çalışma

Year 2021, Volume: 74 Issue: 1, 52 - 59, 30.04.2021
https://doi.org/10.4274/atfm.galenos.2020.18189

Abstract

Objectives: The study aimed to reveal the clinical, laboratory and serological features of patients with antiphospholipid syndrome (APS) followed in a referral center and to demonstrate the possible differences of the patients with recurrent thrombosis.

Materials and Methods: The data of 43 patients with APS, who applied to our center between January 2010 and January 2019, were scrutinized retrospectively. Clinical, laboratory and serological features of the patients were recorded. The patients with and without recurrent thrombosis were compared. P-value <0.05 was considered as statistically significant.

Results: Thirty-three out of 43 patients (76.6%) were female. Fourteen (32.6%) patients were classified as primary APS and 29 (67.4%) patients as secondary APS. Acute cutaneous lupus findings (53.5%), livedo reticularis (18.6%), Raynaud’s phenomenon (18.6%), and thrombocytopenia (30.2%) were the most common clinical findings, which were not included in the classification criteria. Among the females with APS, pregnancy complications occurred in 45.5%. Arterial and/or venous thromboticevents were observed in 40 (93.0%) patients. Venous and arterial thrombosis were found in 76.7% and 32.6% of the patients, respectively. Recurrent thrombosis was detected in 20 (50.0%) of the patients with thrombosis, nine of whom (20.9%) were under anticoagulant treatment. In patients with recurrent thrombosis, the disease duration was longer (p=0.004), arterial thrombosis (p=0.023) and low serum C4 levels (p=0.025) were more frequent.

Conclusion: In this cohort of the patients with APS, we showed that the disease duration was longer, the history of arterial thrombosis and low serum C4 levels were more frequent in the patients with recurrent thrombosis than in the patients without recurrent thrombosis.

Ethical Statement

Etik Kurul Onayı: Ankara Üniversitesi Tıp Fakültesi Etik Kurulu’ndan 12.09.2019 tarihli İ3-102-19 sayılı etik kurul onayı alındı. Hasta Onayı: Retrospektif bir çalışma olduğu için hasta onamı alınmamıştır. Hakem Değerlendirmesi: Editörler kurulunun dışından olan kişiler tarafından değerlendirilmiştir. Yazarlık Katkıları Konsept: A.A., T.M.T., G.K., Dizayn: A.A., T.M.T., G.K., M.E.Y., Veri Toplama veya İşleme: M.Y., A.B.K.D., S.S., Analiz veya Yorumlama: M.E.Y., M.T., Literatür Arama: E.G.A.G., D.Ş., M.L.Y., Yazan: M.E.Y., D.Ş., M.T. Çıkar Çatışması: Yazarlar herhangi bir çıkar çatışması bildirmemektedir. Finansal Destek: Mevcut çalışma için herhangi bir finansal destek alınmamıştır.

Supporting Institution

-

Project Number

-

Thanks

-

References

  • 1. Miyakis S, Lockshin MD, Atsumi T, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4:295-306.
  • 2. Belizna C, Stojanovich L, Cohen-Tervaert JW, et al. Primary antiphospholipid syndrome and antiphospholipid syndrome associated to systemic lupus: Are they different entities? Autoimmun Rev. 2018;17:739-745.
  • 3. Swaak AJ, van de Brink H, Smeenk RJ, et al. Incomplete lupus erythematosus: results of a multicentre study under the supervision of the EULAR Standing Committee on International Clinical Studies Including Therapeutic Trials (ESCISIT). Rheumatology (Oxford). 2001;40:89-94.
  • 4. Asherson RA, Cervera R, de Groot PG, et al. Catastrophic antiphospholipid syndrome: international consensus statement on classification criteria and treatment guidelines. Lupus. 2003;12:530-534.
  • 5. Asherson RA, Cervera R. ‘Primary’, ‘secondary’ and other variants of the antiphospholipid syndrome. Lupus. 1994;3:293-298.
  • 6. Grika EP, Ziakas PD, Zintzaras E, et al. Morbidity, mortality, and organ damage in patients with antiphospholipid syndrome. J Rheumatol. 2012;39:516-523.
  • 7. Cervera R, Piette JC, Font J, et al. Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients. Arthritis Rheum. 2002;46:1019-1027.
  • 8. Alijotas-Reig J, Esteve-Valverde E, Ferrer-Oliveras R, et al. The European Registry on Obstetric Antiphospholipid Syndrome (EUROAPS): A survey of 1000 consecutive cases. Autoimmun Rev. 2019;18:406-414.
  • 9. Cervera R, Khamashta MA, Shoenfeld Y, et al. Morbidity and mortality in the antiphospholipid syndrome during a 5-year period: a multicentre prospective study of 1000 patients. Ann Rheum Dis. 2009;68:1428-1432.
  • 10. Sanna G, D’Cruz D, Cuadrado MJ. Cerebral manifestations in the antiphospholipid (Hughes) syndrome. Rheum Dis Clin North Am. 2006;32:465-490.
  • 11. Hughes GR. Migraine, memory loss, and “multiple sclerosis”. Neurological features of the antiphospholipid (Hughes’) syndrome. Postgrad Med J. 2003;79:81-83.
  • 12. Ricarte IF, Dutra LA, Abrantes FF, et al. Neurologic manifestations of antiphospholipid syndrome. Lupus. 2018;27:1404-1414.
  • 13. Cervera R, Boffa MC, Khamashta MA, et al. The Euro-Phospholipid project: epidemiology of the antiphospholipid syndrome in Europe. Lupus. 2009;18:889-893.
  • 14. de Carvalho JF, Pasoto SG, Appenzeller S. Seizures in primary antiphospholipid syndrome: the relevance of smoking to stroke. Clin Dev Immunol. 2012;2012:981519.
  • 15. Shoenfeld Y, Lev S, Blatt I, et al. Features associated with epilepsy in the antiphospholipid syndrome. J Rheumatol. 2004;31:1344-1348.
  • 16. Rovaris M, Pedroso C, Filippi M. Neuroimaging techniques in the diagnostic work-up of patients with the antiphospholipid syndrome. Curr Rheumatol Rep. 2001;3:301-306.
  • 17. Ramos-Casals M, Campoamor MT, Chamorro A, et al. Hypocomplementemia in systemic lupus erythematosus and primary antiphospholipid syndrome: prevalence and clinical significance in 667 patients. Lupus. 2004;13:777-783.
  • 18. Carbone J, Orera M, Rodríguez-Mahou M, et al. Immunological abnormalities in primary APS evolving into SLE: 6 years follow-up in women with repeated pregnancy loss. Lupus. 1999;8:274-278.
  • 19. Núñez-Álvarez CA, Hernández-Molina G, Bermúdez-Bermejo P, et al. Prevalence and associations of anti-phosphatidylserine/prothrombin antibodies with clinical phenotypes in patients with primary antiphospholipid syndrome: aPS/PT antibodies in primary antiphospholipid syndrome. Thromb Res. 2019;174:141-147.
  • 20. Saccone G, Berghella V, Maruotti GM, et al. Antiphospholipid antibody profile based obstetric outcomes of primary antiphospholipid syndrome: the PREGNANTS study. Am J Obstet Gynecol. 2017;216:525.
  • 21. Vianna JL, Khamashta MA, Ordi-Ros J, et al. Comparison of the primary and secondary antiphospholipid syndrome: a European Multicenter Study of 114 patients. Am J Med. 1994;96:3-9.
  • 22. Abu-Zeinah G, Oromendia C, DeSancho MT. Thrombotic risk factors in patients with antiphospholipid syndrome: a single center experience. J Thromb Thrombolysis. 2019;48:233-239.
  • 23. Galli M, Luciani D, Bertolini G, et al. Lupus anticoagulants are stronger risk factors for thrombosis than anticardiolipin antibodies in the antiphospholipid syndrome: a systematic review of the literature. Blood. 2003;101:1827-1832.
  • 24. Pengo V, Ruffatti A, Legnani C, et al. Clinical course of high-risk patients diagnosed with antiphospholipid syndrome. J Thromb Haemost. 2010;8:237-242.
  • 25. da Silva Saraiva S, Custódio IF, de Moraes Mazetto B, et al. Recurrent thrombosis in antiphospholipid syndrome may be associated with cardiovascular risk factors and inflammatory response. Thromb Res. 2015;136:1174-1178.
  • 26. Mary-Carmen Amigo MAK. Antiphospholipid syndrome: pathogenesis, diagnosis, and management. In: Marc C. Hochberg EMG, Alan J. Silman,, Josef S. Smolen MEW, Michael H. Weisman., editors. Rheumatology (Hochberg). 7th ed. Philadelphia, PA: Elsevier.; 2019. s. 1221-1229.
  • 27. Radin M, Sciascia S, Erkan D, et al. The adjusted global antiphospholipid syndrome score (aGAPSS) and the risk of recurrent thrombosis: Results from the APS ACTION cohort. Semin Arthritis Rheum. 2019;49:464-468.
  • 28. Oku K, Atsumi T, Bohgaki M, et al. Complement activation in patients with primary antiphospholipid syndrome. Ann Rheum Dis. 2009;68:1030-1035.
  • 29. Al-khayat Z, Waheda NE, Shaker NF. Complement C3 and C4 Levels in Recurrent Aborting Women with or without Antiphospholipid and Anticardiolipin Autoantibodies. Ibnosina J Med BS. 2014;6:143-148.
  • 30. Tabacco S, Giannini A, Garufi C, et al. Complementemia in pregnancies with antiphospholipid syndrome. Lupus. 2019;28:1503-1509 31. Crowther MA, Ginsberg JS, Julian J, et al. A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome. N Engl J Med. 2003;349:1133-1138.
  • 32. Finazzi G, Marchioli R, Brancaccio V, et al. A randomized clinical trial of high-intensity warfarin vs. conventional antithrombotic therapy for the prevention of recurrent thrombosis in patients with the antiphospholipid syndrome (WAPS). J Thromb Haemost. 2005;3:848-853.
There are 31 citations in total.

Details

Primary Language English
Subjects Rheumatology and Arthritis
Journal Section Research Article
Authors

Müçteba Enes Yayla 0000-0002-5998-6703

Merve Yüksel 0000-0003-1458-5540

Didem Şahin 0000-0003-3558-5400

Murat Torgutalp This is me 0000-0003-4600-9484

Serdar Sezer 0000-0001-5401-5599

Ayşe Bahar Keleşoğlu Dinçer 0000-0001-8810-2869

Emine Gözde Aydemir Gülöksüz This is me 0000-0003-3619-476X

Mehmet Levent Yüksel 0000-0002-4626-4349

Aşkın Ateş 0000-0003-1966-3333

Tahsin Murat Turgay 0000-0001-5302-4485

Gülay Kınıklı This is me 0000-0002-4006-1022

Project Number -
Publication Date April 30, 2021
Published in Issue Year 2021 Volume: 74 Issue: 1

Cite

APA Yayla, M. E., Yüksel, M., Şahin, D., … Torgutalp, M. (2021). Antifosfolipid Sendromlu Hastaların Klinik Özellikleri ve Tekrarlayan Trombozu Olan Hastaların Farklılıkları, Tek Merkezli Retrospektif Bir Çalışma. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 74(1), 52-59. https://doi.org/10.4274/atfm.galenos.2020.18189
AMA Yayla ME, Yüksel M, Şahin D, et al. Antifosfolipid Sendromlu Hastaların Klinik Özellikleri ve Tekrarlayan Trombozu Olan Hastaların Farklılıkları, Tek Merkezli Retrospektif Bir Çalışma. Ankara Üniversitesi Tıp Fakültesi Mecmuası. April 2021;74(1):52-59. doi:10.4274/atfm.galenos.2020.18189
Chicago Yayla, Müçteba Enes, Merve Yüksel, Didem Şahin, Murat Torgutalp, Serdar Sezer, Ayşe Bahar Keleşoğlu Dinçer, Emine Gözde Aydemir Gülöksüz, et al. “Antifosfolipid Sendromlu Hastaların Klinik Özellikleri Ve Tekrarlayan Trombozu Olan Hastaların Farklılıkları, Tek Merkezli Retrospektif Bir Çalışma”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 74, no. 1 (April 2021): 52-59. https://doi.org/10.4274/atfm.galenos.2020.18189.
EndNote Yayla ME, Yüksel M, Şahin D, Torgutalp M, Sezer S, Keleşoğlu Dinçer AB, Aydemir Gülöksüz EG, Yüksel ML, Ateş A, Turgay TM, Kınıklı G (April 1, 2021) Antifosfolipid Sendromlu Hastaların Klinik Özellikleri ve Tekrarlayan Trombozu Olan Hastaların Farklılıkları, Tek Merkezli Retrospektif Bir Çalışma. Ankara Üniversitesi Tıp Fakültesi Mecmuası 74 1 52–59.
IEEE M. E. Yayla et al., “Antifosfolipid Sendromlu Hastaların Klinik Özellikleri ve Tekrarlayan Trombozu Olan Hastaların Farklılıkları, Tek Merkezli Retrospektif Bir Çalışma”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 74, no. 1, pp. 52–59, 2021, doi: 10.4274/atfm.galenos.2020.18189.
ISNAD Yayla, Müçteba Enes et al. “Antifosfolipid Sendromlu Hastaların Klinik Özellikleri Ve Tekrarlayan Trombozu Olan Hastaların Farklılıkları, Tek Merkezli Retrospektif Bir Çalışma”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 74/1 (April2021), 52-59. https://doi.org/10.4274/atfm.galenos.2020.18189.
JAMA Yayla ME, Yüksel M, Şahin D, Torgutalp M, Sezer S, Keleşoğlu Dinçer AB, Aydemir Gülöksüz EG, Yüksel ML, Ateş A, Turgay TM, Kınıklı G. Antifosfolipid Sendromlu Hastaların Klinik Özellikleri ve Tekrarlayan Trombozu Olan Hastaların Farklılıkları, Tek Merkezli Retrospektif Bir Çalışma. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2021;74:52–59.
MLA Yayla, Müçteba Enes et al. “Antifosfolipid Sendromlu Hastaların Klinik Özellikleri Ve Tekrarlayan Trombozu Olan Hastaların Farklılıkları, Tek Merkezli Retrospektif Bir Çalışma”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 74, no. 1, 2021, pp. 52-59, doi:10.4274/atfm.galenos.2020.18189.
Vancouver Yayla ME, Yüksel M, Şahin D, Torgutalp M, Sezer S, Keleşoğlu Dinçer AB, et al. Antifosfolipid Sendromlu Hastaların Klinik Özellikleri ve Tekrarlayan Trombozu Olan Hastaların Farklılıkları, Tek Merkezli Retrospektif Bir Çalışma. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2021;74(1):52-9.