scholarly journals Anti-Phospholipid Antibody Syndrome with Subdural Hematoma: A Case Report

Pulse ◽  
2018 ◽  
Vol 10 (1) ◽  
pp. 25-28
Author(s):  
MN Uddin ◽  
AKMB Karim ◽  
N Akter ◽  
M Ahmed ◽  
M Orin ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Antiphospholipid Antibodies ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Bleeding Tendency ◽  
Laboratory Studies ◽  
Prolonged Bleeding Time ◽  
Hemorrhagic Complications ◽  
Chiari Syndrome ◽  
Bridging Veins

A 33-year-old man with anti-phospholipid antibody syndrome associated with Budd Chiari syndrome and subdural hematoma. He developed venous thrombosis in his hepatic vein (stenting done) when laboratory studies demonstrated prolongation of activated partial thromboplastin time (APTT). Subdural hematoma demonstrated with Computed tomography (CT) of brain. Laboratory studies revealed thrombocytopenia, prolonged bleeding time and APTT, positive antinuclear antibody and positive test results for both lupus anticoagulant and an anti-cardiolipin antibody, namely antiphospholipid antibodies. Based on these findings, we consider that the tendency of this bleeding may have been due to antiphospholipid antibodies, attacking the platelet membranes and that the bridging veins in the subdural space may be the site at which the bleeding tendency easily appears. Antiphospholipid antibody syndrome accompanied by hemorrhagic complications had rarely been reported. We suggest that special attention should be given to hemorrhagic complications in patients with antiphospholipid antibody syndrome associated with fragility of the vessels and/or platelet dysfunction and on anticoagulant (warfarin).Pulse Vol.10 January-December 2017 p.25-28

IgA Anticardiolipin Antibodies – Relation with other Antiphospholipid Antibodies and Clinical Significance

1998 ◽  
Vol 79 (02) ◽  
pp. 282-285 ◽  
Author(s):  
Josep Ordi-Ros ◽  
Francesc Monegal-Ferran ◽  
Nuria Martinez ◽  
Fina Cortes-Hernandez ◽  
Miquel Vilardell-Tarres ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Antiphospholipid Antibodies ◽  
Fetal Loss ◽  
Cross Sectional Study ◽  
Anticardiolipin Antibodies ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Serum Samples ◽  
Cross Sectional ◽  
Vein Thrombosis

SummaryObjective: To evaluate the usefulness of IgA antiphospholipid antibodies as markers of thrombosis and/or antiphospholipid antibody syndrome. Patients and Methods: A cross-sectional study design in a tertiary, university-based, autoimmune reference hospital. Seven-hundred ninety-five patients classified into five different groups – autoimmune diseases (255), deep vein thrombosis (153), transitory ischemic attacks (108), obstetric complications (196), infectious diseases (83) and controls (81) – were tested for IgA, IgG and IgM aPL, and lupus anticoagulant. Plasma and serum samples were drawn for detection of aPL using an internationally standardized ELISA method and LA was carried out using coagulometric assays. Results: True IgA aPL were found only in two patients with systemic lupus erythematosus; these patients were also positive to IgG aPL. Conclusion: The incidence of true positivity to IgA anticardiolipin antibodies is extremely low. Their determination was not helpful in diagnosing the antiphospholipid syndrome or in explaining thrombotic events or aPL related manifestations – fetal loss – in the groups studied.

scholarly journals Successful Pregnancy Outcome with High dose Heparin Therapy in Antiphospholipid Antibody Syndrome

1970 ◽  
Vol 11 (2) ◽  
pp. 205-206
Author(s):  
MP Ranjith ◽  
Ranjith Divya ◽  
S Meera ◽  
Shabu Bahuleyan ◽  
Roney Joseph Kuryan
Keyword(s):  
Antiphospholipid Antibodies ◽  
Heparin Therapy ◽  
High Dose ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Syndrome Patient ◽  
Successful Pregnancy ◽  
Dose Heparin ◽  
History Of ◽  
Recurrent Abortions

Antiphospholipid antibody syndrome is an autoimmune disease characterized by thrombosis, both arterial andvenous, recurrent spontaneous abortion and the persistence of positive antiphospholipid antibodies. Placentalthrombosis is believed to be the cause of recurrent abortions, characteristic of the syndrome. We report a pregnantwith antiphospholipid antibody syndrome patient with history of recurrent miscarriages and managed successfullywith high dose heparin.Keywords: Antiphospholipid antibody syndrome; recurrent intra uterine death; HeparinDOI: 10.3329/jom.v11i2.5476J MEDICINE 2010; 11 : 205-206

scholarly journals Antiphospholipid Antibody Syndrome and Infertility

2019 ◽  
Vol 41 (10) ◽  
pp. 621-627
Author(s):  
Vivian de Oliveira Rodrigues ◽  
Adriana de Góes e Silva Soligo ◽  
Gabriel Duque Pannain
Keyword(s):  
Antiphospholipid Antibodies ◽  
Fetal Loss ◽  
Female Infertility ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Therapeutic Approaches ◽  
Negative Effects ◽  
The Past ◽  
New Therapeutic Approaches ◽  
Abortion Complications

AbstractAntiphospholipid antibody syndrome (APS) is a systemic, autoimmune, prothrombotic disease characterized by persistent antiphospholipid antibodies (aPLs), thrombosis, recurrent abortion, complications during pregnancy, and occasionally thrombocytopenia. The objective of the present study was to review the pathophysiology of APS and its association with female infertility. A bibliographic review of articles of the past 20 years was performed at the PubMed, Scielo, and Bireme databases. Antiphospholipid antibody syndrome may be associated with primary infertility, interfering with endometrial decidualization and with decreased ovarian reserve. Antiphospholipid antibodies also have direct negative effects on placentation, when they bind to the trophoblast, reducing their capacity for invasion, and proinflammatory effects, such as complement activation and neutrophil recruitment, contributing to placental insufficiency, restricted intrauterine growth, and fetal loss. In relation to thrombosis, APS results in a diffuse thrombotic diathesis, with global and diffuse dysregulation of the homeostatic balance. Knowing the pathophysiology of APS, which is closely linked to female infertility, is essential for new therapeutic approaches, specialized in immunomodulation and inflammatory signaling pathways, to provide important advances in its treatment.

scholarly journals Epidemiological, clinical and immune factors that influence the persistence of antiphospholipid antibodies in leprosy

2019 ◽  
Vol 59 (1) ◽  
Author(s):  
Sandra Lúcia Euzébio Ribeiro ◽  
Helena Lúcia Alves Pereira ◽  
Antonio Luiz Boechat ◽  
Neusa Pereira Silva ◽  
Emilia Ionue Sato ◽  
...  
Keyword(s):  
Antiphospholipid Antibodies ◽  
Specific Treatment ◽  
Binary Logistic Regression ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Pregnancy Morbidity ◽  
Glycoprotein I ◽  
Leprosy Patients ◽  
Immunological Factors ◽  
Bacterial Index

Abstract Introduction Antiphospholipid antibodies (aPL) are described in individuals with leprosy without the clinical features of antiphospholipid antibody syndrome (APS), a condition involving thromboembolic phenomena. We have described the persistence of these antibodies for over 5 years in patients with leprosy after specific treatment. Objectives To determine whether epidemiological, clinical and immunological factors played a role in the long-term persistence of aPL antibodies in leprosy patients after multidrug therapy (MDT) had finished. Methods The study sample consisted of 38 patients with a diagnosis of leprosy being followed up at the Dermatology and Venereology Outpatient Department at the Alfredo da Matta Foundation (FUAM) in Manaus, AM. ELISA was used to detect anticardiolipin (aCL) and anti-β2 glycoprotein I (anti-β2GPI) antibodies. Patients were reassessed on average of 5 years after specific treatment for the disease (MDT) had been completed. Results Persistence of aPL antibodies among the 38 leprosy patients was 84% (32/38), and all had the IgM isotype. Mean age was 48.1 ± 15.9 years, and 23 (72.0%) were male. The lepromatous form (LL) of leprosy was the most common (n = 16, 50%). Reactional episodes were observed in three patients (9.4%). Eighteen (47.37%) were still taking medication (prednisone and/or thalidomide). Mean IgM levels were 64 U/mL for aCL and 62 U/mL for anti-β2GPI. In the multivariate binary logistic regression the following variables showed a significant association: age (p = 0.045, OR = 0.91 and CI 95% 0.82–0.98), LL clinical presention (p = 0.034; OR = 0.02 and CI 95% = 0.0–0.76) and bacterial index (p = 0.044; OR = 2.74 and CI 95% = 1.03–7.33). We did not find association between prednisone or thalidomide doses and positivity for aPL (p = 0.504 and p = 0.670, respectively). No differences in the variables vascular thrombosis, pregnancy morbidity, diabetes, smoking and alcoholism were found between aPL-positive and aPL-negative patients. Conclusion Persistence of positivity for aPL antibodies was influenced by age, clinical presentation and bacterial index. However, further studies are needed to elucidate the reason for this persistence, the role played by aPL antibodies in the disease and the B cell lineages responsible for generation of these antibodies.

Antiphospholipid Syndrome: A Review

2018 ◽  
Vol 2 (02) ◽  
pp. 51-58
Author(s):  
Md. Motahar Hossain ◽  
Md. Akhter Hossain ◽  
Yasmin Rahman ◽  
Md. Kamrul Hasan
Keyword(s):  
Antiphospholipid Syndrome ◽  
Antiphospholipid Antibodies ◽  
Arterial Thrombosis ◽  
Anticardiolipin Antibodies ◽  
Vitamin K Antagonist ◽  
Classification Criteria ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Pregnancy Morbidity ◽  
Pregnancy And Postpartum

Antiphospholipid syndrome (APS) is an autoimmune disease characterized by venous thromboembolism, arterial thrombosis, and obstetric morbidities in the setting of persistently positive levels of antiphospholipid antibodies. It may be primary or secondary. The latest classification criteria (Sydney 2006) recognize just three tests to define this syndrome- lupus anticoagulant, anticardiolipin antibodies and anti-?2-glycoprotein-1 antibodies. Treatment of thrombotic events involves lifelong anticoagulation with vitamin K antagonist warfarin. Antiphospholipid antibody syndrome (APS) with only pregnancy morbidity is treated with thromboprophylaxis with heparin during pregnancy and postpartum for 6 weeks. In this review we discuss the pathogenesis, diagnosis, treatment and prognosis of the APS.

Point of Care Monitoring of the International Normalized Ratio in Patients with Antiphospholipid Antibodies.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1855-1855 ◽  
Author(s):  
Stephanie L. Perry ◽  
Gregory P. Samsa ◽  
Thomas L. Ortel
Keyword(s):  
Whole Blood ◽  
Antiphospholipid Antibodies ◽  
Point Of Care ◽  
Method Comparison ◽  
Correlation Coefficients ◽  
International Normalized Ratio ◽  
Absolute Difference ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Antibody Levels

Abstract Warfarin is effective in decreasing recurrent thrombosis in patients with antiphospholipid antibody syndrome (APS). Antiphospholipid antibodies (APAs) can influence the results of clotting tests in a subset of these patients, which can be a major obstacle in monitoring warfarin. In this study, 59 patients receiving warfarin for a diagnosis of APS were compared to 49 patients receiving warfarin for atrial fibrillation (AF) with regard to consistency between International Normalized Ratio (INR) results obtained from two Point of Care (POC) monitors and a standard plasma-based method used in the coagulation laboratory. INR results were obtained using a fingerstick for whole blood on the ProTime® monitor (International Technidyne Corp, ITC, Edison, NJ) and by venipuncture using both citrated and non-citrated whole-blood on a HEMOCHRON®Signature (Hr. Sig.) monitor (ITC). Parallel INR measurements were obtained on an MDA-180 analyzer (bioMeriéux, Durham, NC), using Simplastin-HTF. Additional tests included chromogenic factor Xa (CFXa) and tests for APAs (antiphospholipid, anti-β2-glycoprotein I [β2GPI], and antiprothrombin ELISA’s). Insufficient blood was obtained from 5 patients for testing with the ProTime® (3 AF, 2 APS). For an additional 5 patients, all with APS, sufficient blood was obtained, but an INR could not be determined by the instrument (8%). Single INR results on the ProTime® were obtained from 2 of these patients on repeat testing. The data were analyzed with the 100 patients who had at least one INR result with the ProTime®. Analyses included determination of the means of absolute differences between each method of obtaining INR results, correlations between INR results and CFXa results, and correlations with APAs results. Systematic differences were found for each INR method comparison, ranging from 0.24±0.23 to 0.41±0.29, with correlation coefficients ranging from 0.54 to 0.80. The differences were similar for AF and APS patients for all INR comparisons with the exception of the results comparing the standard plasma-based method with the ProTime®, which showed a mean absolute difference of 0.24 for AF patients and 0.39 for APS patients (p=0.01). Preliminary data analysis did not show perfect calibration between the CFXa and the different methods for obtaining INR results for either patient group. Correlation coefficients ranged from 0.3 to 0.7 when comparing CFXa to each INR method, and the best correlation was between the standard plasma INR and the CFXa for patients with AF (0.65). Review of testing for APAs at the time of INR testing revealed that 10 patients with AF had elevated antibody levels (20%; all by antiphospholipid ELISA only and most only minimally elevated), compared to 27 patients with APAs (45%, with 21 having elevated anti-β2 GPI antibody levels). The five patients with non-measurable ProTime® INRs had elevated anti-β2GPI levels and generally higher INRs with the Hr. Sig., but CFXa results were not supratherapeutic. In conclusion, these results suggest that in a subset of patients with APAs, the ProTime® will not yield any results and can not be used due to the internal QC set of the monitor. APA testing did not specifically identify which APS patients would most likely have problems with INR testing.

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