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FRI0177 The spectrum of clinical manifestations of antiphospholipid antibody syndrome in the general hospital
  1. TI Reitblat1,
  2. E Dorodnikov2,
  3. I Polishchuk3,
  4. D Zamir3,
  5. E Kahana2
  1. 1Rheumatology
  2. 2Neurology
  3. 3Internal Medicine Department D, Barzilai Medical Center, Ashkelon, Israel


Background APS is recognised with growing incidence in many fields of medicine. It is clinically and immunologically diverse condition and may affect any organ of the body and display a broad spectrum of manifestations. The majority of published studies have been reported from a tertiary referral hospitals. We decided to study the incidence and clinical spectrum of APS in a general hospital.

Objectives To examine the spectrum of clinical manifestations of antiphospholipid antibody syndrome (APS) in the acute general hospital of the southern area of Israel.

Methods Clinical records of patients who were discharged with diagnosis of APS during the years 1990–2000 were reviewed.

Results A total of 22 patients fulfilled criteria of APS (accordingly to Asherson?s criteria, 1988) with 38 clinical events. Primary APS was found in 15 patients and secondary in 7 patients. There were 19 female and 3 male, mean age was 42.1 years (from 29 to 56). Most of the patients (20 out of 22) were diagnosed after 1995, showing increased awareness of this syndrome among the stuff.

16 thrombotic events occurred: 6 stroke (27%), 4 acute myocardial infarction (18%), 3 venous thromboembolic event (13.6%), 3 recurrent abortion (13.6%). 32 nonthrombotic events were found: 8 headache (36.3%), 6 thrombocytopenia (27%), 3 skin rashes (13.6%), 1 amaurosis fugax (4.5%), 1 catastrophic APS (4.5%) 1 progressive supranuclear pulsy (PSP) (4.5%).

All patients suffering from acute myocardial infarction were patients with SLE, thus showing that APS is an additional risk factor for ischaemic heart disease in such patients.

Headache was an additional symptom in the patients, diagnosed as having APS – in all 6 patients with stroke, one with amaurosis fugax and one with venous thromboembolic event.

Patient with PSP features had magnetic resonance imaging of brain and blood test results characteristic to APS (our unpublished data).

Conclusion The study shows that APS is not an uncommon disease. It is important for the internist and the specialist to be aware of the clinical manifestations of APS. Its inclusion in the differential diagnosis of arterial or venous thrombosis with or without thrombocytopenia in patients is obligatory at the present time.

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