Autoimmune haemolytic anaemia and antiphospholipid antibodies in paediatrics: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Mira Merashli ◽  
Alessia Arcaro ◽  
Maria Graf ◽  
Fabrizio Gentile ◽  
Paul R. J. Ames
Keyword(s):  
Systematic Review ◽  
Haemolytic Anaemia ◽  
Antiphospholipid Antibodies ◽  
Meta Analysis ◽  
Autoimmune Haemolytic Anaemia

scholarly journals Antiphospholipid Antibodies and Autoimmune Haemolytic Anaemia: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 21 (11) ◽  
pp. 4120 ◽  
Author(s):  
Paul R.J. Ames ◽  
Mira Merashli ◽  
Tommaso Bucci ◽  
Daniele Pastori ◽  
Pasquale Pignatelli ◽  
...  
Keyword(s):  
Haemolytic Anaemia ◽  
Lupus Erythematosus ◽  
Antiphospholipid Antibodies ◽  
Meta Analysis ◽  
Classification Criteria ◽  
Autoimmune Haemolytic Anaemia ◽  
Systemic Lupus ◽  
Pooled Prevalence ◽  
Pubmed Search ◽  
The Relationship

The relationship between antiphospholipid antibodies (aPL) and autoimmune haemolytic anaemia (AIHA) has never been systematically addressed. The aim of this study is to assess the link between aPL and AIHA in adult systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). This study performed an EMBASE/PubMed search from inception to June 2019 and meta-analysis using Peto’s odds ratios. The pooled prevalence (PP) of IgG/IgM anticardiolipin (aCL) and lupus anticoagulant (LA) was greater in AIHA +ve than AIHA −ve patients (34.7% vs. 27.6%, p = 0.03; 33.3% vs. 21.8%, p < 0.0001; 20.9% vs. 8.3%, p = 0.01). The PP of AIHA was greater in: (1) IgG and IgM aCL +ve than −ve patients (21.8% vs. 11.1%, p = 0.001 and 18.7% vs. 6.3%, p < 0.0001), (2) in SLE related APS than in primary APS patients (22.8% vs. 3.9% p < 0.0001), (3) in APS +ve than APS −ve SLE patients (23.2% vs. 8.4%, p = 0.01), and (4) in thrombotic APS than non-thrombotic APS/SLE patients (26.8% vs. 10%, p = 0.03). The PP of IgG/IgM aCL and LA was greater in DAT +ve than DAT −ve patients (42.4% vs. 12.8%, p < 0.0001; 26.2% vs. 12.8%, p = 0.03 and 29.2% vs. 15.7%, p = 0.004 respectively). It was found that AIHA prevalence is maximal in SLE with aPL/APS, low-moderate in SLE without aPL and minimal in PAPS. Moreover, AIHA is rightly included among the classification criteria for SLE but not for APS/aPL. The significance of an isolated DAT positivity remains unclear in this setting

scholarly journals Epidemiology of Secondary Warm Autoimmune Haemolytic Anaemia—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (6) ◽  
pp. 1244
Author(s):  
Stinne Tranekær ◽  
Dennis Lund Hansen ◽  
Henrik Frederiksen
Keyword(s):  
Haemolytic Anaemia ◽  
Lupus Erythematosus ◽  
Meta Analysis ◽  
Underlying Disease ◽  
Age At Diagnosis ◽  
Autoimmune Haemolytic Anaemia ◽  
Sex Distribution ◽  
Number Of Patients ◽  
Study Results ◽  
Full Text Review

Background: Warm autoimmune haemolytic anaemia (wAIHA) is a haemolytic disorder, most commonly seen among adults and is classified as either primary or secondary to an underlying disease. We describe the age and sex distribution and the proportion of secondary wAIHA. Method: We retrieved 2635 published articles, screened abstracts and titles, and identified 27 articles eligible for full-text review. From these studies, we extracted data regarding number of patients, sex distribution, age at diagnosis, number of patients with secondary wAIHA, and whether the patients were diagnosed through local or referral centres. All data were weighted according to the number of included patients in each study. Results: 27 studies including a total of 4311 patients with wAIHA, of which 66% were females, were included. The median age at diagnosis was 68.7 years, however, wAIHA affected all ages. The mean proportion of secondary wAIHA was 49%, most frequently secondary to systemic lupus erythematosus. The proportions of secondary wAIHA reported from primary vs. referral centres were 35% vs. 59%, respectively. Conclusion: This review consolidates previously reported gender distribution. The higher proportion of secondary wAIHA in referral centres suggests that the most severely affected patients are disproportionally more frequent in such facilities.

Antiphospholipid antibodies in epilepsy: A systematic review and meta-analysis

2018 ◽  
Vol 17 (8) ◽  
pp. 755-767 ◽  
Author(s):  
Md. Asiful Islam ◽  
Fahmida Alam ◽  
Cinzia Cavestro ◽  
Cornelia Calcii ◽  
Teguh Haryo Sasongko ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antiphospholipid Antibodies ◽  
Meta Analysis

Relevance of antiphospholipid antibodies in multiple sclerosis: A systematic review and meta analysis

2017 ◽  
Vol 46 (6) ◽  
pp. 810-818 ◽  
Author(s):  
Mira Merashli ◽  
Jose′ Delgado Alves ◽  
Fabrizio Gentile ◽  
Paul R.J. Ames
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Antiphospholipid Antibodies ◽  
Meta Analysis

Antiphospholipid antibodies and lower extremity peripheral artery disease: A systematic review and meta-analysis

2020 ◽  
Vol 50 (6) ◽  
pp. 1291-1298
Author(s):  
Mira Merashli ◽  
Tommaso Bucci ◽  
Daniele Pastori ◽  
Pasquale Pignatelli ◽  
Vincenzo Marottoli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Antiphospholipid Antibodies ◽  
Meta Analysis ◽  
Peripheral Artery ◽  
Artery Disease

Antiphospholipid antibodies and lower extremity peripheral arterial disease - a systematic review and meta-analysis

VASA ◽  
2016 ◽  
Vol 45 (4) ◽  
pp. 325-330 ◽  
Author(s):  
Beatriz Gavier ◽  
Fernando Vazquez ◽  
Esteban Gandara
Keyword(s):  
Systematic Review ◽  
Peripheral Arterial Disease ◽  
Lower Extremity ◽  
Antiphospholipid Antibodies ◽  
Meta Analysis ◽  
Arterial Disease ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Disease Case ◽  
Peripheral Arterial

Abstract. Background: Despite being an important risk factor for venous thromboembolism and ischaemic stroke, the role of antiphospholipid antibodies in patients with peripheral arterial disease remains a matter of debate. The aim of this study was to evaluate the association of persistently elevated antiphospholipid antibodies and lower extremity peripheral arterial disease. Methods: We conducted a systematic review of electronic databases including MEDLINE, EUROPUBMED and EMBASE to assess the prevalence of antiphospholipid antibodies in patients with lower extremity peripheral arterial disease. Case-control studies were included if they reported the prevalence of antiphospholipid antibodies in patients with lower extremity peripheral arterial disease. Two reviewers (FV and EG) independently assessed the eligibility of all articles. The primary outcome measure was the odds ratio (OR) for the prevalence of antiphospholipid antibodies patients with lower extremity peripheral arterial disease, along with the corresponding 95 % confidence intervals (CIs). Results: Our initial electronic search identified 128 relevant abstracts, of which two studies were included. Antiphospholipid antibodies were found in 50/571 patients with lower extremity peripheral arterial disease and 13/490 of the controls, OR 3.32 (95 % CI = 1.49 to 7.4). In those with critical limb ischaemia, the prevalence of antiphospholipid antibodies was elevated compared to controls, pooled OR 4.78 (95 % CI = 2.37 to 9.65). Conclusions: Our systematic review and meta-analysis suggests that the prevalence of persistently elevated levels of antiphospholipid antibodies is increased in patients with lower extremity peripheral diseases when compared to healthy controls, especially in those with critical limb ischaemia.

Heparin Does Not Increase Live Births in Pregnant Women with Previous Unexplained Recurrent Miscarriages: A Systematic Review and Meta-Analysis

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 504-504
Author(s):  
Murtadha K. Al-Khabori ◽  
Zainab S. Al-Hosni ◽  
Hajer M. Al Ghaithi ◽  
Altaf M. Al Maamari ◽  
Wafa S. Bessiso ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Pregnant Women ◽  
Antiphospholipid Antibodies ◽  
Odds Ratio ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Inherited Thrombophilia ◽  
Recurrent Miscarriages ◽  
Live Births

Abstract Abstract 504 Background: The impact of heparin in pregnant women with previous unexplained recurrent miscarriages remains uncertain. The use of heparin in this patient population has been increasing with the hope of improving the rate of live births. We performed a systematic review of the randomized clinical trials addressing this question. Methods: We searched MEDLINE (searched July 1st 2012), CENTRAL (Issue 7 of 12, July 2012), American Society of Hematology (searched July 1st 2012), clinical trials registries (http://clinicaltrials.gov/, searched July 1st 2012), and bibliographies of relevant studies for randomized clinical trials comparing heparin (unfractionated or low molecular weight) to other best care approaches. Use of aspirin was allowed in either study arms. Included patients were pregnant women over 18 years of age with previous recurrent unexplained miscarriages (at least two at any trimester). We performed a meta-analysis using random effects models to estimate the pooled odds ratio. Statistical heterogeneity was calculated by using the I2 statistic. Results: Eight trials proved eligible, five of which provided data from 1141 patients that could be included in the meta-analysis and three of which remain unpublished. Only the subgroup of patients with no antiphospholipid antibodies or inherited thrombophilia was included. There was a total of 839 live births observed. Enoxaparin was used in four trials and nadroparin was used in one trial. All trials randomized patients before the 8th week of gestation. There were 430 live births (among a total of 561 pregnancies) and 409 live births (among a total of 580 pregnancies) in the heparin and other best care treatment arms respectively. The difference between the two treatment arms was not statistically significant with a pooled odds ratio of 1.49 (95% confidence interval: 0.84, 2.66; P = 0.17). There was a substantial heterogeneity among the results of different trials (Chi2 = 14.91, P = 0.005; I2 = 73%). Conclusions: Available evidence suggests that heparin does not increase live births in pregnant women with previous unexplained recurrent miscarriages with no evidence of antiphospholipid antibodies or inherited thrombophilia. Future trials should explore new treatment strategies. Disclosures: No relevant conflicts of interest to declare.

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