Long-term follow-up of antiphospholipid syndrome: real-life experience from a single center

Lupus ◽  
2020 ◽  
Vol 29 (9) ◽  
pp. 1050-1059
Author(s):  
Rosa Serrano ◽  
Guillermo J Pons-Estel ◽  
Gerard Espinosa ◽  
Rosana M. Quintana ◽  
Joan C Reverter ◽  
...  
Keyword(s):  
Antiphospholipid Syndrome ◽  
Life Experience ◽  
Disease Onset ◽  
Real Life ◽  
Clinical Manifestations ◽  
Current Treatment ◽  
Single Center ◽  
Live Births ◽  
Laboratory Features ◽  
Long Term Follow Up

Objective The objective of this paper is to assess the prevalence of the main clinical manifestations and laboratory features at disease onset and during the ensuing 10 years of a large cohort of patients with antiphospholipid syndrome (APS) from a single center. Methods The study included all consecutive APS patients followed longitudinally in our center from 2003 to 2013. Descriptive statistics for demographics, clinical and laboratory features and mortality were performed. Results A total of 160 patients were included. Most of them, 128 (78.8%), were women and the mean (SD) age at diagnosis was 39.1 (14.0) years. The majority of them, 104 (65.0%), had primary APS, 36 (22.5%) had APS associated with systemic lupus erythematous, and 20 (12.5%) had APS associated with other autoimmune disease. During the study period, thrombotic events occurred in 27 (16.9%) patients, the most common being strokes, nonbacterial thrombotic endocarditis and deep venous thrombosis. Regarding obstetric morbidity, 18 women (14.3%) became pregnant and 90% of pregnancies succeeded in having live births. The most common obstetric complication was early pregnancy loss (15% of pregnancies). Prematurity (11.1% of live births) and intrauterine growth restriction (5.6% of live births) were the most frequent fetal morbidities. Ten (6.3%) patients died and the most frequent causes of death were severe thrombosis, hemorrhage, and cancer. Three (0.9%) cases of catastrophic APS occurred. The survival probability at 10 years was 93.8%. Conclusions Patients with APS develop significant morbidity and mortality despite current treatment. It is imperative to identify prognostic factors and therapeutic measures to prevent these complications.

scholarly journals 65 Antiphospholipid syndrome long term follow up: real life experience of a single centre

2017 ◽  
Author(s):  
RM Serrano Morales ◽  
G Pons-Estel ◽  
R Quintana ◽  
G Espinosa Garriga ◽  
R Cervera Segura
Keyword(s):  
Antiphospholipid Syndrome ◽  
Life Experience ◽  
Real Life ◽  
Single Centre ◽  
Long Term Follow Up

scholarly journals Patterns of Organ Involvement and Outcomes of SLE: A Real-Life Experience in Lupus Clinic

2020 ◽  
Vol 21 (2) ◽  
pp. 89-92
Author(s):  
Md Mujibur Rahman ◽  
Md Moniruzzaman ◽  
SK Jakaria Been Sayeed ◽  
Rashedul Hassan ◽  
Md Uzzwal Mallik ◽  
...  
Keyword(s):  
Standard Treatment ◽  
Life Experience ◽  
Tertiary Care ◽  
Real Life ◽  
Clinical Manifestations ◽  
Current Treatment ◽  
Organ Involvement ◽  
Organ Systems ◽  
Major Organ ◽  
Tertiary Care Hospitals

SLE is one of the most common autoimmune disorders of women of childbearing age.It often manifests with various constitutional symptoms as well as combination of major organ involvement and outcome varies in different studies with current treatment. The present study is to see the patterns of organ involvement and outcomes at least after 6 months with standard treatment. This retrospective study was conducted in lupus clinic of two largest tertiary care hospitals in Dhaka city of Bangladesh over 2010 to 2019. It included 277 patients of SLE, diagnosed on the basis of ACR lupus diagnostic criteria and ACR lupus nephritis guideline and had received standard treatment. Outcomes were assessed by SLEDAI. The most common clinical manifestations were fever (71.8%), joint pain (71.4%), oral ulceration (54.8%), alopecia (36.4%), butterfly rash (28.5%), photosensitivity (32.1%) and Raynaud’s phenomenon (16.6%). Commonly involved major organ-systems were renal (41.5%), CNS (16.6%), pulmonary (7.2%), cardiac (3.2%) and hematological (12.2%). Renal biopsy was done in 91cases and the histology showed majority (37.3%) in class-IV. With standard treatment, a significant reduction of mean serum creatinine, proteinuria and SLEDAI was observed at least after 6 months. A total 35(12.63%) flares and 6 (2.17%) deaths occurred during the course of treatment. Renal and CNS are the most commonly involved major organ systems next to skin and joints. The overall outcome is favorable with standard treatment. J MEDICINE JUL 2020; 21 (2) : 89-92

scholarly journals Single-center real-life experience with low-dose ipilimumab monotherapy in adjuvant setting for patients with stage III melanoma

2019 ◽  
Vol 29 (6) ◽  
pp. 648-654 ◽  
Author(s):  
Joanna Mangana ◽  
Florentia Dimitriou ◽  
Ralph Braun ◽  
Sabine Ludwig ◽  
Reinhard Dummer ◽  
...  
Keyword(s):  
Low Dose ◽  
Life Experience ◽  
Real Life ◽  
Stage Iii ◽  
Adjuvant Setting ◽  
Single Center ◽  
Stage Iii Melanoma

scholarly journals Epidemiology and analysis of invasive fungal infections in patients withhematological malignancies: a single-center real-life experience

2017 ◽  
Vol 47 ◽  
pp. 1535-1542 ◽  
Author(s):  
Nur SOYER ◽  
Hatice Demet KİPER ÜNAL ◽  
Filiz VURAL ◽  
Fahri ŞAHİN ◽  
Mahmut TÖBÜ ◽  
...  
Keyword(s):  
Life Experience ◽  
Fungal Infections ◽  
Real Life ◽  
Invasive Fungal Infections ◽  
Single Center

scholarly journals Omalizumab Treatment for Atopic Severe Persistant Asthma: A Single-Center, Long-Term, Real-Life Experience with 38 Patients

2018 ◽  
Vol 19 (4) ◽  
pp. 187-192 ◽  
Author(s):  
Murat Turk ◽  
◽  
Sakine Nazik Bahcecioglu ◽  
Nuri Tutar ◽  
Fatma Sema Oymak ◽  
...  
Keyword(s):  
Life Experience ◽  
Real Life ◽  
Single Center

scholarly journals Apremilast generic for the treatment of active psoriatic arthritis: A single-center real-life experience from India

2020 ◽  
Vol 15 (1) ◽  
pp. 46
Author(s):  
Dhiraj Dhoot ◽  
Sanjiv Amin ◽  
Aneesa Kapadia ◽  
Hanmant Barkate
Keyword(s):  
Psoriatic Arthritis ◽  
Life Experience ◽  
Real Life ◽  
Single Center

scholarly journals Single Center Real Life Experience with Regorafenib in Patients with Metastatic Colorectal Cancer

2020 ◽  
Author(s):  
Melek KARAKURT ERYILMAZ ◽  
Mustafa KARAAGAC ◽  
Murat ARAZ ◽  
Fatma YALCIN MUSRI ◽  
Mehmet ARTAC
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Life Experience ◽  
Real Life ◽  
Single Center

scholarly journals Direct oral anticoagulants in patients with antiphospholipid syndrome: a cohort study

Lupus ◽  
2019 ◽  
Vol 29 (1) ◽  
pp. 37-44 ◽  
Author(s):  
K Malec ◽  
E Broniatowska ◽  
A Undas
Keyword(s):  
Cohort Study ◽  
Antiphospholipid Syndrome ◽  
Major Bleeding ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Real Life ◽  
Double Positive ◽  
Increased Risk ◽  
Long Term Follow Up

Objectives Despite controversies, direct oral anticoagulants (DOACs) are increasingly used in antiphospholipid syndrome (APS). We investigated the safety and efficacy of DOACs versus vitamin K antagonists (VKAs) in real-life consecutive APS patients. Patients and methods In a cohort study of 176 APS patients, which included 82 subjects who preferred DOACs or had unstable anticoagulation with VKAs, we recorded venous thromboembolism (VTE), cerebrovascular ischemic events or myocardial infarction, along with major bleeding or clinically relevant non-major bleeding (CRNMB). Results APS patients were followed for a median time of 51 (interquartile range 43–63) months. Patients on DOACs and those on VKAs were similar with regard to baseline characteristics. APS patients treated with DOACs had increased risk of recurrent thromboembolic events and recurrent VTE alone compared with those on VKAs (hazard ratio (HR) = 3.98, 95% confidence interval (CI): 1.54–10.28, p = 0.004 and HR = 3.69, 95% CI: 1.27–10.68, p = 0.016, respectively) with no differences between rivaroxaban and apixaban or single- or double-positive and triple-positive APS. Thromboembolism on DOACs was associated with older age (median 52 versus 42 years, p = 0.008) and higher global APS score (median 13 versus 8.5, p = 0.013). Patients on DOACs had increased risk of major bleeding or CRNMB (HR = 3.63, 95% CI: 1.53–8.63, p = 0.003), but rates of gastrointestinal bleeds (HR = 3.36, 95% CI: 0.70–16.16, p = 0.13) and major bleeds or CRNMB other than heavy menstrual bleeding (HR = 2.45, 95% CI: 0.62–9.69, p = 0.2) were similar in both treatment groups. Conclusion During long-term follow-up of real-life APS patients, DOACs are less effective and less safe as VKAs in the prevention of thromboembolism.

Characterization of the Clinical and Laboratory Features of Primary and Secondary Antiphospholipid Syndrome in a Cohort of Egyptian Patients

2020 ◽  
Vol 16 (4) ◽  
pp. 304-310 ◽  
Author(s):  
Geilan Abd el-Moniem ◽  
Kamal El-Garf ◽  
Nesreen Sobhy ◽  
Sally Elmaghraby
Keyword(s):  
Antiphospholipid Syndrome ◽  
Age At Onset ◽  
Disease Onset ◽  
P Value ◽  
Significant Difference ◽  
Egyptian Patients ◽  
Laboratory Features ◽  
Systemic Manifestations ◽  
Males And Females

Objective: To study the clinical and laboratory features of Antiphospholipid Syndrome (APS) in a cohort of Egyptian patients and compare between primary and secondary type on the basis of clinical and immunological pattern. Patients and Methods: We reviewed the medical records of 148 antiphospholipid syndrome patients following in Rheumatology and Rehabilitation department, Cairo University. Clinical and immunological data were recorded; subsequently, our patients were compared based on the type of APS, patient’s age and sex. Results: The cohort consisted of 148 patients, 135 females (91.2%) and 13 males (8.8%). The mean age at onset was 23.6 ±7.66 years. 28.4% of patients had primary while, 71.6% of patients had secondary APS. : Patients with secondary APS presented more frequently with the following manifestations compared to patients with primary APS: systemic manifestations (56.6% versus 4.8%, P-value: 0.00), venous thrombosis (41.5% versus 19%, P-value: 0.009), cutaneous vasculitis (19.8% versus 4.8%, P-value: 0.023), thrombocytopenia (37.7% versus 11.9%, P-value: 0.002) and hemolytic anemia (28.3% versus 4.8%, P-value: 0.002). On the other hand, total obstetric manifestations were more common in primary APS (92.5% versus 75%, P-value: 0.007). : Juvenile onset APS presented more frequently with systemic (68.8%, p-value: 0.02), neurological (62.5%, p-value: 0.01) and renal manifestations (31.3%, p-value: 0.005). No statistically significant difference was found between males and females in our cohort. Conclusion: APS has broad spectrum manifestations, which may vary according to the patient’s age at disease onset and association with other diseases. Further more, different ethnicities may show different presentations.

Sign in / Sign up

Export Citation Format

Share Document