Xiao-mei Leng1, Xiao-min Liu, Mai-xing Ai, Xiao-feng Zeng, Fu-lin Tang. 1. Department of Rheumatology & Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical Colleges, Beijing 100730, China.
Abstract
OBJECTIVE: To investigate the clinical manifestations, diagnosis and treatment of anti-phospholipid syndrome (APS). METHODS: 61 patients with defined APS admitted from Jan 1986 to Dec 2002 were analyzed retrospectively. RESULTS: 10 patients with primary APS and 51 patients with secondary APS were analyzed. Women were affected 3.1 times as that of men. 48 of the 51 (94.1%) patients with secondary APS were complicated with other autoimmune diseases, including 33 cases (64.7%) of systemic lupus erythematosus. Vascular thrombosis was presented in around 80.3% of the patients in this study. Thrombosis frequently involved the gastrointestinal system (21 cases, 22.6%), pulmonary system (19 cases, 20.4%), the cerebral vascular system (17 cases, 18.3%), lower limb deep venous system (16 cases, 17.2%), and infrequently coronary arteries or adrenal glands. The abnormal pregnancy rate in the 37 married women was 45.9%. The prevalence of anticardiolipin antibody (ACL) and lupus anticoagulant (LA) was 77.0% and 62.3% respectively. LA was associated with ACL. CONCLUSION: APS occurs most commonly among young women, is a disorder characterized by recurrent venous or arterial thrombosis and/or fetal losses associated with positive ACL or LA. Thrombosis frequently occurs in gastrointestinal system, pulmonary system, cerebral vascular system and deep venous system. The association between clinical features of APS and antiphospholipid antibody is significant. LA is a stronger risk factor for thrombosis and abnormal pregnancy than ACL. Antiplatelet with low-dosage aspirin and long-term anticoagulation are main therapeutics.
OBJECTIVE: To investigate the clinical manifestations, diagnosis and treatment of anti-phospholipid syndrome (APS). METHODS: 61 patients with defined APS admitted from Jan 1986 to Dec 2002 were analyzed retrospectively. RESULTS: 10 patients with primary APS and 51 patients with secondary APS were analyzed. Women were affected 3.1 times as that of men. 48 of the 51 (94.1%) patients with secondary APS were complicated with other autoimmune diseases, including 33 cases (64.7%) of systemic lupus erythematosus. Vascular thrombosis was presented in around 80.3% of the patients in this study. Thrombosis frequently involved the gastrointestinal system (21 cases, 22.6%), pulmonary system (19 cases, 20.4%), the cerebral vascular system (17 cases, 18.3%), lower limb deep venous system (16 cases, 17.2%), and infrequently coronary arteries or adrenal glands. The abnormal pregnancy rate in the 37 married women was 45.9%. The prevalence of anticardiolipin antibody (ACL) and lupus anticoagulant (LA) was 77.0% and 62.3% respectively. LA was associated with ACL. CONCLUSION:APS occurs most commonly among young women, is a disorder characterized by recurrent venous or arterial thrombosis and/or fetal losses associated with positive ACL or LA. Thrombosis frequently occurs in gastrointestinal system, pulmonary system, cerebral vascular system and deep venous system. The association between clinical features of APS and antiphospholipid antibody is significant. LA is a stronger risk factor for thrombosis and abnormal pregnancy than ACL. Antiplatelet with low-dosage aspirin and long-term anticoagulation are main therapeutics.