scholarly journals Gastrointestinal symptoms as the first manifestation of antiphospholipid syndrome

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaojuan Zou ◽  
Zhongqi Fan ◽  
Ling Zhao ◽  
Weiling Xu ◽  
Jin Zhang ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Antiphospholipid Syndrome ◽  
Clinical Manifestation ◽  
High Titer ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Recurrent Abdominal Pain ◽  
Anticardiolipin Antibodies ◽  
Glycoprotein I ◽  
Gastrointestinal Lesions

Abstract Background Antiphospholipid syndrome (APS) is an acquired pre-thrombotic autoimmune condition, which produces autoantibodies called antiphospholipid antibodies (APL) against phospholipid-binding plasma proteins. The diagnosis of APS requires at least one of Sapporo standard clinical manifestations and one laboratory criteria (persistently medium/high titer anticardiolipin antibodies, and/or medium/high titer anti-β2-glycoprotein I antibodies, and/or a positive lupus anticoagulant test). Gastrointestinal lesions are rarely reported in APS patients. APS cases with recurrent abdominal pain as the first clinical manifestation are even rarer. Case presentation This report describes an APS case with recurrent abdominal pain as the first clinical manifestation of antiphospholipid syndrome. The patient has a history of two miscarriages. Computed tomography of the abdomen confirmed mesenteric thrombosis and intestinal obstruction while laboratory tests for serum antiphospholipid and anti-β2-glycoprotein I antibodies were positive. This led to the diagnosis of APS. Conclusions This paper provides useful information on gastrointestinal manifestations and APS, also including a brief literature review about possible gastrointestinal symptoms of APS.

Recurrent Abdominal Pain in School Age Children

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Mohammed Hamdy Saber ◽  
Ahmed Tohamy Ahmed Ibrahim ◽  
Ola Adel Abdellah Mahdy
Keyword(s):  
Abdominal Pain ◽  
Urine Analysis ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Recurrent Abdominal Pain ◽  
School Age Children ◽  
Stool Examination ◽  
School Age ◽  
Functional Abdominal Pain ◽  
Cross Sectional

Abstract Background Abdominal pain defined as any type of pain or discomfort that occurs in any area from the lower chest to the groin. Abdominal pain is symptom of a wide variety of mild to serious diseases, disorders, conditions. Abdominal pain can result from infection, malignancy, inflammation, obstruction and other abnormal processes. Aim of the Work To define the causes of recurrent abdominal pain among a sample of school age children. Subjects and Methods This cross sectional study was carried out to evaluate those children who presented to the Pediatric Outpatient Clinic, Children Hospital, Ain Shams University because of recurrent abdominal pain they were diagnosed in the pediatric Gastroenterology unit between June 2016 and July 2017. History taking included full analysis of abdominal pain, associated gastrointestinal symptoms and associated systemic manifestations. Examination included anthropometric measurements, general and local abdominal examination. Routine investigations included complete blood counts, urine analysis and culture, microscopic stool examination and pelviabdominal US. Other specific investigations were selected according to clinical manifestations to reach an organic cause. After reaching the definitive diagnosis, patients were classified into 2 groups organic causes and functional abdominal pain. Results During the study period, 100 children presented with recurrent abdominal pain. Results revealed that only 28% of the recurrent abdominal pain causes were attributed to organic factors; the most commonly encountered organic causes of recurrent abdominal pain were urinary tract infection (12%) while 72% of children presented with functional recurrent abdominal pain. The most common causes of function recurrent abdominal pain in our study was irritable bowel syndrome. Conclusion Most of the cases of RAP among school age children are due to functional abdominal pain (72%).

scholarly journals Gastrointestinal disorders in COVID-19 patients: a great imitator

2021 ◽  
Author(s):  
Ari Fahrial Syam
Keyword(s):  
Abdominal Pain ◽  
Clinical Manifestation ◽  
Respiratory Tract Infections ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Etiologic Agent ◽  
Gastrointestinal Disorders ◽  
Delayed Treatment ◽  
Gastrointestinal Complaints ◽  
Tract Infections

Up to this point, the coronavirus disease 2019 (COVID-19) pandemic is still ongoing. Some studies with a large number of cases have reported its clinical manifestations, concluding that the disease is a great imitator. Patients may present with symptoms other than the main symptoms of respiratory tract infections, such as diarrhea, abdominal pain, nausea, or vomiting, which may sometimes cause a delayed treatment in managing COVID-19 patients. Reports of various hospitals have also demonstrated gastrointestinal complaints as a clinical manifestation in those patients. The patients may come with gastrointestinal symptoms as their early clinical manifestation, or the gastrointestinal symptoms may be found in hospitalized COVID-19 patients, which indeed can be explained since the SARS-CoV-2, an etiologic agent of COVID-19 infection, can obviously be found along the gastrointestinal tract. Hence, the virus can be found in fecal and anal, and therefore, rectal swabs can be used as a diagnostic tool for COVID-19 infection.

Antiphospholipid Syndrome: Diagnostic Aspects of Lupus Anticoagulants

2001 ◽  
Vol 86 (07) ◽  
pp. 83-91 ◽  
Author(s):  
J. Arnout
Keyword(s):  
Monoclonal Antibodies ◽  
Antiphospholipid Syndrome ◽  
Autoimmune Disorder ◽  
Coagulation Factors ◽  
Laboratory Diagnosis ◽  
Anticardiolipin Antibodies ◽  
Lupus Anticoagulants ◽  
Glycoprotein I ◽  
Antigen Antibody

SummaryAntiphospholipid syndrome (APS) is an autoimmune disorder in which antiphospholipid antibodies (aPL) are thought to be involved in the development of venous and/or arterial thrombosis. APL found in this syndrome are antibodies directed against a variety of phospholipid (PL) binding-proteins of which β2-glycoprotein I (β2GPI) and prothrombin are considered to be the major antigens. Some of these antibodies prolong PL-dependent clotting reactions and are termed lupus anticoagulants (LA). Autoimmune aPL which bind through β2GPI to cardiolipin are called anticardiolipin antibodies (aCL). Clinical studies indicate that LA is a stronger risk factor for thrombosis than aCL. The production of monoclonal antibodies against β2GPI and prothrombin has enabled us to understand the mechanism by which LA prolong coagulation in vitro. LA form bivalent antigen-antibody complexes with increased affinity for PL which compete with coagulation factors for the same catalytic surface. These LA positive monoclonal antibodies may be helpful in further improving the laboratory diagnosis of LA.

scholarly journals Anticardiolipin Antibodies in Patients with Chronic Hepatitis C Virus Infection: Characterization in Relation to Antiphospholipid Syndrome

2000 ◽  
Vol 7 (2) ◽  
pp. 241-244 ◽  
Author(s):  
Josep Ordi-Ros ◽  
Julieta Villarreal ◽  
Francesc Monegal ◽  
Silvia Sauleda ◽  
Ignacio Esteban ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Antiphospholipid Syndrome ◽  
Clinical Manifestations ◽  
Cross Reactivity ◽  
Healthy Controls ◽  
Glycoprotein I ◽  
Chronic Hepatitis C Virus

ABSTRACT The antiphospholipid syndrome (APS) is usually defined by the association of clinical manifestations that comprise venous and/or arterial thrombosis, recurrent fetal losses, and thrombocytopenia, along with the presence of anticardiolipin (aCL) antibodies and/or lupus anticoagulant. Various infectious diseases can induce aCL; however, these antibodies are not usually associated with thrombotic events, as happens with autoimmune diseases, in which these antibodies need the presence of β2-glycoprotein I. Levels of immunoglobulin G (IgG) and IgM aCL antibodies were determined by enzyme-linked immunosorbent assay for 243 patients with chronic hepatitis C virus (HCV) infection and 100 healthy controls. Clinical events of APS, the level of β2-glycoprotein dependence of aCL, the presence of cryoglobulins and other autoantibodies, and cross-reactivity between purified aCL and HCV were evaluated. Positive results for aCL antibodies were found more frequently (3.3%) for the patients with HCV infection than for healthy controls (0%). All positive aCL antibodies were β2-glycoprotein I independent. No significant association was found between aCL antibodies and clinical manifestations of APS, neither was one found between the presence of other autoantibodies or cryoglobulins and that of aCL. Finally, no cross-reactivity between aCL antibodies and HCV antigens was observed. As previously reported, aCL antibodies seem to be an epiphenomenon, and they do not have clinical or laboratory significance in HCV patients.

Atherosclerosis and the antiphospholipid syndrome: A link unravelled?

Lupus ◽  
1998 ◽  
Vol 7 (2_suppl) ◽  
pp. 140-143 ◽  
Author(s):  
Y Shoenfeld ◽  
D Harats ◽  
J George
Keyword(s):  
Antiphospholipid Syndrome ◽  
Antiphospholipid Antibodies ◽  
Dominant Role ◽  
Clinical Manifestations ◽  
Humoral Response ◽  
Arterial System ◽  
Glycoprotein I ◽  
Shock Proteins ◽  
Modified Forms ◽  
Progression Of Atherosclerosis

Atherosclerosis is a multifactorial disease that involves the arterial system. Recent data suggest that immune and autoimmune factors play a dominant role in mediating the progression of atherosclerosis. Among these factors, humoral response to modified forms of LDL and heat-shock proteins has been shown to be influential. The antiphospholipid syndrome (APS) entails clinical manifestations that result from a hypercoagulable state. Antibodies to phospholipids and to β2-glycoprotein I have been suggested to confer the tendency to thrombosis. In a set of recent studies, we have been able to show that generation of antiphospholipid antibodies in mice is associated with enhanced atherosclerosis. These findings imply that APS and atherosclerosis may share a common etiologic background, which may have direct implications for the management of both conditions.

scholarly journals Endoscopic study of upper gastrointestinal mucosal lesion in chronic renal failure

2017 ◽  
Vol 5 (4) ◽  
pp. 1316
Author(s):  
Manoj Gupta ◽  
Atul Shende
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Mucosal Lesion ◽  
Ulcer Disease ◽  
Upper Gi ◽  
Gastrointestinal Lesions ◽  
Duration Of Disease ◽  
Upper Gastrointestinal

Background: Chronic renal failure is a syndrome complex results from progressive and irreversible destruction of nephrons regardless of cause. This diagnosis implies that GFR is known to have been reduced for atleast 3 to 6 months. To study the clinical manifestations and assess the type and prevalence of upper gastrointestinal lesions and to correlate the clinical and biochemical parameters with upper GI mucosal lesion in chronic renal failure patients.Methods: Fifty CRF patients from nephrology and Medicine OPD, admitted in the department of Medicine, M.Y. Hospital, Indore, during January 2002 to April 2003 were studied. A detailed History, clinical examination, Urine Examination, renal Function test, U.S.G. was done and then upper GI Endoscopy was performed.Results: Thirty-six males and fourteen females (n=50) were studied. Most common age group was 41-50 years; commonest GI symptom was Anorexia (100%) and Nausea was present in (94%) of patients and GI bleed was seen in (8%). The common upper GI lesion were gastritis (28%), Oesophagitis (16%) and Duodenitis (12%). No patients had Gastric or Duodenal Ulcers. Majority of patients had creatinine clearance between 5-10 ml /min and most of the patients had duration of disease between 11-20 months.Conclusions: Gastrointestinal symptoms are very frequent in CRF patients. There is a high incidence of inflammatory charges of gastrointestinal mucosa in patients of CRF and chronic uremic patients are not at high risk of developing ulcer disease. There is no correlation of these gastrointestinal symptoms and inflammatory changes with age, sex, severity and duration of disease.

Is There an Additional Value in Detecting Anticardiolipin and Anti-β2 glycoprotein I IgA Antibodies in the Antiphospholipid Syndrome?

2020 ◽  
Vol 120 (11) ◽  
pp. 1557-1568
Author(s):  
Walid Chayoua ◽  
Dong-mei Yin ◽  
Hilde Kelchtermans ◽  
Gary W. Moore ◽  
Jean-Christophe Gris ◽  
...  
Keyword(s):  
Antiphospholipid Syndrome ◽  
Immunoglobulin A ◽  
Clinical Manifestations ◽  
Pregnancy Morbidity ◽  
Medical Centers ◽  
Glycoprotein I ◽  
Iga Antibodies ◽  
Obstetric Aps ◽  
Current Criterion ◽  
Additional Value

Abstract Background Anticardiolipin (aCL) and anti-β2 glycoprotein I (aβ2GPI) immunoglobulin A (IgA) antiphospholipid antibodies (aPL) have shown to associate with thrombosis and pregnancy morbidity. However, inclusion of IgA aPL in the classification criteria of the antiphospholipid syndrome (APS) has been debated. We investigated the value of aCL and aβ2GPI IgA aPL in the detection of thrombosis and pregnancy morbidity in addition to the current aPL panel for APS. Methods We included 1,068 patients from eight European medical centers: 259 thrombotic APS patients, 122 obstetric APS patients, 204 non-APS thrombosis patients, 33 non-APS obstetric patients, 60 APS patients with unspecified clinical manifestations, 196 patients with autoimmune diseases, and 194 controls. aCL and aβ2GPI IgG/M/A were detected with four commercial assays and lupus anticoagulant was determined by the local center. Results Positivity for IgA aPL was found in 17 to 26% of the patients with clinical manifestations of APS and in 6 to 13% of the control population. Both aCL and aβ2GPI IgA were significantly associated with thrombosis and pregnancy morbidity. Isolated IgA positivity was rare in patients with clinical manifestations of APS (0.3–5%) and not associated with thrombosis and/or pregnancy morbidity. Addition of IgA to the current criterion panel did not increase odds ratios for thrombosis nor pregnancy morbidity. Conclusion aCL and aβ2GPI IgA are associated with clinical manifestations of APS. However, isolated IgA positivity was rare and not associated with thrombosis or pregnancy morbidity. These data do not support testing for aCL and aβ2GPI IgA subsequent to conventional aPL assays in identifying patients with thrombosis or pregnancy morbidity.

Pathophysiological insights into the antiphospholipid syndrome

2017 ◽  
Vol 37 (03) ◽  
pp. 202-207 ◽  
Author(s):  
Davit Manukyan ◽  
Nadine Müller-Calleja ◽  
Karl Lackner
Keyword(s):  
Antiphospholipid Syndrome ◽  
Clinical Manifestations ◽  
Future Research ◽  
Scientific Debate ◽  
Pregnancy Morbidity ◽  
Anionic Phospholipids ◽  
The Third ◽  
Glycoprotein I ◽  
Underlying Mechanisms

SummaryThe antiphospholipid syndrome (APS) is characterized by venous and/or arterial thrombosis and severe pregnancy morbidity in presence of antiphospholipid antibodies (aPL). While there is compelling evidence that aPL cause the clinical manifestations of APS, the underlying mechanisms are still a matter of scientific debate. This is mainly related to the broad heterogeneity of aPL. There are three major types of aPL: The first one binds to (anionic) phospholipids, e.g. cardiolipin, in absence of other factors (cofactor independent aPL). The second type binds to phospholipids only in presence of protein cofactors, e.g. ß2-glycoprotein I (ß2GPI) (cofactor dependent aPL). The third type binds to cofactor proteins directly without need for phospholipids. It is widely believed that cofactor independent aPL (type 1) are associated with infections and, more importantly, non-pathogenic, while pathogenic aPL belong to the second and in particular to the third type. This view, in particular with regard to type 1 aPL, has not been undisputed and novel research data have shown that it is in fact untenable. We summarize the available data on the pathogenetic role of aPL and the implications for diagnosis of APS and future research.

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