A CASE OF RECURRENT MISCARRIAGES WITH ANAEMIA

Young Females ◽

Pregnancy Morbidity ◽

Appropriate Treatment ◽

History Of ◽

Auto Antibody

APLAS/ APS is an auto antibody mediated acquired thrombophilia with recurrent arterial / venous thrombosis and pregnancy morbidity . It primarily affects females . 5 cases per 1,00,000 population Diagnosis of APLAS should be considered in cases of thrombosis, CVA in individuals less than 55yrs of age . We report a case of a 21 yr old female who had history of jaundice ( on and off episodes) excessive menstrual bleeding with past history of 3 miscarriages. She was screened and evaluated for Autoimmune diseases and found to have ANTIPHOSPHOLIPID ANTIBODY SYNDROME . She was kept on anticoagulants and aspirin . And patient was doing well on follow up. Any miscarriages/ anaemia in young females needs active investigation so that appropriate treatment can be started to halt the disease process.

Antiphospholipid Syndrome in a Pregnant Female Presenting with Severe Thrombocytopenia and Bleeding

Case Reports in Medicine ◽

10.1155/2015/234878 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3

Author(s):

Kunal Mahajan ◽

Virender Katyal ◽

Suvrat Arya ◽

Meha Shrama

Keyword(s):

Antithrombotic Therapy ◽

Severe Thrombocytopenia ◽

Antithrombotic Treatment ◽

Thrombotic Risk ◽

Pregnancy Morbidity ◽

Recurrent Pregnancy Losses ◽

History Of

The antiphospholipid antibody syndrome (APS) is defined by the persistent presence of antiphospholipid antibodies in patients with recurrent venous or arterial thromboembolism or pregnancy morbidity. Antithrombotic therapy is the mainstay of treatment given the high risk of recurrent thromboembolism that characterizes this condition. Despite the prothrombotic nature of APS, thrombocytopenia is present in a proportion of patients, which can complicate management and limit the use of antithrombotic therapy. The mechanism of APS-associated thrombocytopenia is multifactorial and its relation to thrombotic risk is poorly characterized. The presence of thrombocytopenia does not appear to reduce thrombotic risk in patients with APS, who can develop thromboembolic complications necessitating antithrombotic treatment. In these cases, treatment of the thrombocytopenia may be necessary to facilitate administration of antithrombotic agents. We present such a pregnant lady with history of recurrent pregnancy losses who presented with severe thrombocytopenia and bleeding manifestations, who was subsequently diagnosed to have antiphospholipid antibody syndrome. She was initially managed with steroids and when her platelet counts improved, antithrombotic therapy was started. She delivered an uneventful and successful pregnancy outcome without any complications during follow-up.

Antiphospholipid Antibody Syndrome Presenting with Hemichorea

Case Reports in Rheumatology ◽

10.1155/2012/471543 ◽

2012 ◽

Vol 2012 ◽

pp. 1-2 ◽

Cited By ~ 1

Author(s):

Yezenash Ayalew ◽

Fazlihakim Khattak

Keyword(s):

First Trimester ◽

Anticardiolipin Antibodies ◽

Blurred Vision ◽

Significant Family History ◽

History Of ◽

The Right ◽

Time Of Presentation ◽

Underlying Pathophysiology

A 25-year-old Bangladeshi lady presented to neurology with a three-month history of involuntary movements of her right arm, associated with loss of power. There was progression to the right leg, and she subsequently developed episodes of slurred speech and blurred vision. At the time of presentation, she was 12 weeks pregnant and the symptoms were reported to have started at conception. Past medical history was unremarkable apart from one first trimester miscarriage and there was no significant family history suggestive of a hereditary neurological condition. MRI of the head revealed no abnormalities but serology showed positive antinuclear antibodies (ANAs) at a titre of 1/400. Further investigations revealed strongly positive anticardiolipin antibodies (>120) and positive lupus anticoagulant antibodies. The patient had a second miscarriage at 19 weeks gestation strengthening the possibility that the chorea was related to antiphospholipid antibody syndrome and she was started on a reducing dose of Prednisolone 40 mg daily and aspirin 300 mg daily. Six months later, she had complete resolution of neurological symptoms. There are several reports of chorea as a feature of antiphospholipid syndrome, but no clear consensus on underlying pathophysiology.

Oral Antithrombotic Use Among Myocardial Infarction Patients

Annals of Pharmacotherapy ◽

10.1345/aph.1c038 ◽

2003 ◽

Vol 37 (1) ◽

pp. 143-146 ◽

Cited By ~ 2

Author(s):

Menno E van der Elst ◽

Nelly Cisneros-Gonzalez ◽

Cornelis J de Blaey ◽

Henk Buurma ◽

Anthonius de Boer

Keyword(s):

Myocardial Infarction ◽

Record Linkage ◽

Antithrombotic Therapy ◽

Past History ◽

Oral Anticoagulants ◽

Antiplatelet Agents ◽

Antithrombotic Treatment ◽

History Of ◽

Using Data

OBJECTIVE To examine the use of oral antithrombotics (i.e., antiplatelet agents, oral anticoagulants) after myocardial infarction (MI) in the Netherlands from 1988 to 1998. METHODS Retrospective follow-up of 3800 patients with MI, using data from the PHARMO Record Linkage System. RESULTS From 1988 to 1998, oral antithrombotic treatment increased significantly from 54.0% to 88.9%. In 1998, only 75.8% of patients who experienced a MI in the late 1980s received oral antithrombotic treatment compared with 94.4% of those who experienced a recent MI. CONCLUSIONS Oral antithrombotics were considerably underused in patients with a past history of MI. Therefore, these patients should be reviewed for antithrombotic therapy to assess whether their failure to use oral antithrombotics was right or wrong, and whether treatment should be initiated if possible.

Pyoderma Gangrenosum Mimicking Antiphospholipid Antibody Syndrome in a Child With Juvenile Systemic Lupus Erythematosus

10.21203/rs.3.rs-89162/v1 ◽

2020 ◽

Author(s):

metin kaya gürgöze ◽

Aslıhan Kara ◽

Mehmet yusuf sarı ◽

İlknur Çalık ◽

Saadet Akarsu

Keyword(s):

Systemic Lupus Erythematosus ◽

Skin Biopsy ◽

Pyoderma Gangrenosum ◽

Lupus Erythematosus ◽

Anticoagulation Therapy ◽

Anticardiolipin Antibody ◽

Systemic Lupus ◽

History Of

Abstract Background: Although pyoderma gangrenosum (PG) -like lesions have been rarely described in adults with the antiphospholipid antibody syndrome (APS) and systemic lupus erythematosus (SLE), the occurrence of PG as a preceding manifestation of APS in children with SLE has not been reported until. We present a young girl with SLE and APS who developed progressive extstensive ulcerations that were consistent with PG.Case presentation: A 14-year-old girl with a 2-year history of SLE was admitted to our department, complaining painful crusted ulcerations on her legs. Skin biopsy was reported as PG. However, she did not respond to immunosuppressive therapy administered. When her skin biopsy findings is reassessed in keeping with the positive anticardiolipin antibody results, superficial small vessel microthrombosis was observed. Diagnosis of APS and PG developing secondary to SLE were made. It was resulted in marked clinical improvement with anticoagulation therapy in addition to immunosuppressives as is recommended in APS. Conclusions: Based in clinical, pathological and response to proposed treatment, we can state that PG -like lesions in children with SLE could be considered as a secondary form of APS.

The antiphospholipid (antibody) syndrome

Oxford Handbook of Rheumatology ◽

10.1093/med/9780199587186.003.0011 ◽

2011 ◽

pp. 343-352

Author(s):

Alan J. Hakim ◽

Gavin P.R. Clunie ◽

Inam Haq

Keyword(s):

Systemic Lupus Erythematosus ◽

Autoimmune Diseases ◽

Venous Thrombosis ◽

Antiphospholipid Syndrome ◽

Lupus Erythematosus ◽

Lupus Anticoagulant ◽

Systemic Lupus ◽

Pregnancy Morbidity

Introduction 344 Epidemiology and pathology 345 Clinical features of antiphospholipid syndrome 346 Treatment of antiphospholipid syndrome 348 Catastrophic antiphospholipid syndrome 350 The antiphospholipid syndrome (APS) was first described in the 1980s and comprises arterial and venous thrombosis with or without pregnancy morbidity in the presence of anticardiolipin (ACL) antibodies or the lupus anticoagulant (LAC). It can be primary, or secondary to other autoimmune diseases, most commonly systemic lupus erythematosus (SLE) (...

Audit of safety, efficacy, and cost-effectiveness of local anaesthetic cystodiathermy

Annals of The Royal College of Surgeons of England ◽

10.1308/003588410x12699663904835 ◽

2010 ◽

Vol 92 (8) ◽

pp. 706-709 ◽

Cited By ~ 13

Author(s):

Kim Davenport ◽

Francis X Keeley ◽

Anthony G Timoney

Keyword(s):

Cost Effectiveness ◽

Local Anaesthetic ◽

Past History ◽

Transitional Cell ◽

General Anaesthetic ◽

Patient Anxiety ◽

Bladder Transitional Cell Carcinoma ◽

Flexible Cystoscopy ◽

History Of

INTRODUCTION The aim of this study was to audit our experience of cystodiathermy under local anaesthetic (LA) at the time of flexible cystoscopy for recurrent superficial bladder transitional cell carcinoma (TCC). PATIENTS AND METHODS A total of 264 flexible cystoscopies were performed on patients with a past history of TCC. The number and site of recurrences were recorded and selected patients were offered cystodiathermy. Patient tolerability was noted. At follow-up, any recurrence was recorded. RESULTS Eighty patients (30%) had 91 procedures showing one or more recurrences. Fifty-one of the 80 patients (64%) were treated with cystodiathermy under LA. All completed treatment. Forty-five (88%) tolerated the procedure well. Forty-seven (92%) treatments were completed within 5 min. At a median follow-up of 15 weeks, 30 (59%) treated patients had no recurrence and three (6%) had recurrence at the site of treatment. CONCLUSIONS LA cystodiathermy is an effective and well-tolerated alternative to general anaesthetic cystodiathermy that enables treatment at the time of detection and may, thereby, reduce patient anxiety.

Spontaneous dyskinesia and parkinsonism in never-medicated, chronically ill patients with schizophrenia: 18-month follow-up

The British Journal of Psychiatry ◽

10.1192/bjp.181.2.135 ◽

2002 ◽

Vol 181 (2) ◽

pp. 135-137 ◽

Cited By ~ 15

Author(s):

R. G. McCreadie ◽

R. Padmavati ◽

R. Thara ◽

T. N. Srinivasan

Keyword(s):

Natural History ◽

Disease Process ◽

Chronically Ill ◽

Abnormal Involuntary Movements ◽

Syndrome Scale ◽

History Of ◽

Chronically Ill Patients ◽

Negative Syndrome ◽

Over Time

BackgroundSpontaneous dyskinesia and parkinsonism have been reported in never-medicated patients with schizophrenia but there has been no previous study of the natural history of these conditions.AimsTo determine the prevalence of spontaneous dyskinesia and parkinsonism in a group of never-medicated, chronically ill patients with schizophrenia on two occasions separated by an 18-month interval.MethodDyskinesia was assessed by the Abnormal Involuntary Movements Scale using Schooler and Kane criteria for its presence; parkinsonism by the Simpson and Angus scale; and mental state by the Positive and Negative Syndrome Scale for schizophrenia.ResultsThirty-seven patients were examined on two occasions. Nine (24%) had dyskinesia on both occasions, 12 (33%) on one occasion and 16 (43%) on neither occasion. Twenty-one (57%) had dyskinesia on at least one occasion. Thirteen patients (35%) had parkinsonism on at least one occasion.ConclusionsSpontaneous dyskinesia and parkinsonism fluctuate over time. The former was found on at least one occasion in the majority of patients. It is an integral part ofthe schizophrenic disease process.

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

Journal of Medicine ◽

10.3329/jom.v11i2.5476 ◽

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 ◽

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

Pulmonary Hemorrhage in Antiphospholipid Antibody Syndrome

The Journal of Rheumatology ◽

10.3899/jrheum.120205 ◽

2012 ◽

Vol 39 (8) ◽

pp. 1628-1631 ◽

Cited By ~ 7

Author(s):

ANAT SCHEIMAN ELAZARY ◽

MATAN J. COHEN ◽

SUHAIL AAMAR ◽

ZVI DRANITZKI ◽

OSHRAT TAYER-SHIFMAN ◽

...

Keyword(s):

Mitral Valve ◽

Mitral Valve Disease ◽

High Titer ◽

Clinical Manifestations ◽

Pulmonary Hemorrhage ◽

Valve Disease ◽

Cns Involvement ◽

Pregnancy Morbidity

Objective.To characterize the clinical manifestations of patients with antiphospholipid antibody syndrome (APS) and pulmonary hemorrhage (PH).Methods.We performed a retrospective, single-center analysis of patients with APS who were followed up from 1980 to 2011. Of these patients, only those who fulfilled the Sydney criteria for APS were included. Patients with APS that manifested with PH were called the PHAPS group. The rest of the patients with APS served as controls. Clinical manifestations were compared between the PHAPS group and controls.Results.Sixty-three patients fulfilled the criteria for APS. Thirteen experienced PH and were included in the PHAPS group. Seventy-five percent of the patients with PHAPS and 22% of the controls had mitral valve disease (p = 0.001). Central nervous system (CNS) involvement (cerebrovascular accident, seizures) was present in 61% and 16% of the patients with PHAPS and controls, respectively (p = 0.001). Skin involvement (livedo reticularis, chronic leg ulcers) was present in 54% and 8% of the patients with PHAPS and controls (p = 0.001). Pregnancy morbidity occurred in 87.5% and 32.5% of the patients with PHAPS and controls (p = 0.005). Ninety-two percent and 83% of the patients with PHAPS had high-titer immunoglobulin γ (IgG) anticardiolipin and β2-glycoprotein I IgG antibodies compared to 43% and 30% of the controls (p = 0.002, p < 0.001, respectively).Conclusion.Patients with PHAPS were more likely than controls to have mitral valve disease, skin disease, CNS involvement, and pregnancy morbidity as well as high-titer APS. PHAPS seems to be a unique subgroup of all patients with APS.

A 3-year follow-up of a patient with acute renal failure caused by thrombotic microangiopathy related to antiphospholipid syndrome: case report

Lupus ◽

10.1177/0961203316682098 ◽

2016 ◽

Vol 26 (7) ◽

pp. 777-782 ◽

Cited By ~ 2

Author(s):

X-J Zhou ◽

M Chen ◽

S-X Wang ◽

F-D Zhou ◽

M-H Zhao

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Case Report ◽

Plasma Exchange ◽

Thrombotic Microangiopathy ◽

Rapid Progression ◽

Histopathological Diagnosis ◽

Antiphospholipid Antibody Syndrome

Background Microvascular manifestations of antiphospholipid antibody syndrome in the kidneys include acute renal failure, thrombotic microangiopathy and hypertension. Therapy has been largely empiric. Case report A 49-year-old Chinese man presented with anuric acute renal failure without abundant proteinuria and heavy haematuria, but markedly low levels of urinary sodium, potassium and chlorine upon admission. On day 1 of hospitalization, his thrombocytopenia, anaemia and renal failure showed rapid progression. The presence of lupus anticoagulant and vascular ischaemia of the small vessels in renal arteriography were also observed. Anticoagulants, continuous renal replacement therapy, glucocorticoids and six sessions of plasma exchange were started. After the fourth plasma exchange (on day 20), his urine output increased and began to normalize. On day 25, haemodialysis was stopped and his general condition gradually improved. A renal biopsy was subsequently performed, and the histopathological diagnosis was thrombotic microangiopathy due to antiphospholipid antibody syndrome. A further 3-year follow-up showed that his haemoglobin level, platelet count and serum creatinine were within the normal range, with stable blood pressure. Conclusion Treatment modalities such as anticoagulation, immunosuppression and plasma exchange are likely to be necessary when severe acute renal failure combined with thrombotic microangiopathy present in nephropathy of antiphospholipid antibody syndrome.