Background There is an increased risk of thrombotic events and obstetric morbidities in individuals with antiphospholipid antibodies (APAs) compared with the general population. The risk of complications is further increased in those patients who have a rheumatic diseases and antibody positivity.
Objectives The purpose of this study is to determine the clinical findings and their relationship with the profile of antiphospholipid antibodies in patients with rheumatic disease, of the Division of Rheumatology of the Hospital Regional Universitario José Ma. Cabral y Baez, Dominican Republic.
Methods Patients with 18 years of age and above, with a confirmed rheumatic disease was eligible for enrollment; those with positive titers for APAs, that met the inclusion and exclusion criteria, were included in our study. The institutional review board approved the protocol.
This is a transverse study, with retro-prospective data gathering from patients and their medical records. Demographic information at the time of APA measurement and medical information regarding the rheumatic disease and clinical course were collected from the patient's medical record, with a follow-up of 10 years.
Results 40 patients were included in this study. The male to female ratio was 19:1; mean age was 36±10 years. A large number of patients (13 patients, 32.5%) were asymptomatic for antiphospholipid syndrome (APS) at the time of this study; eight patients (20%) were carriers without defining manifestations. Ten patients (25%) were categorized as vascular APS and five patients (12.5%) as obstetric APS; three patients (7.5%) had vascular and obstetric APS. One patient presented with catastrophic APS. In evaluating such specific profile of antiphospholipid antibodies, aCL was observed that corresponded to the antibody most frequently identified with IgG isotypes (52.5%) and IgM 47.5%. The lupus anticoagulant (LA) corresponded to the second most common (37.5%). The isotypes of the anti-B2GP-I were identified in less proportion. We report 89 pregnancies during the follow, with 29 abortions and 60 live births, of which 12 were premature and 11 born with intrauterine growth restrictions.
Conclusions The most frequent clinical manifestations were livedo reticularis, vascular thrombosis in lower extremities, Raynaud's phenomenon, migraine, cerebrovascular disease, thrombocytopenia, leukopenia, and alteration of urine sediment.
Hughes GR. Antiphospholipid Syndrome Hughes Syndrome: 10 Clinical Topics. Lupus 2010; 19:343–6.
Musial J. Antiphospholipid Antibodies and Thrombosis. Thromb Res 2012; 129:345–7.
Erkan D, Barbhaiya M, George D et al. Moderate Versus High-Titer Persistently Anticardiolipin Antibody Positive Patients: Are They Clinically Different and Does High-Titer Anti-Beta 2-Glycoprotein-I Antibody Positivity Offer Additional Predictive Information? Lupus 2010; 19:613–9.
Petri M. Update on Anti-Phospholipid Antibodies in SLE: The Hopkins' Lupus Cohort. Lupus 2010; 19:419–23.
Tarr T, Lakos G, Bhattoa HP et al. Analysis of Risk Factors for the Development of Thrombotic Complications in Antiphospholipid Antibody Positive Lupus Patients. Lupus 2007; 16: 39–45.
Disclosure of Interest None declared
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.