Stanley Niznik1, Micha J Rapoport2,3, Orly Avnery4, Aharon Lubetsky3,5, Ronen Shavit1, Martin H Ellis3,4, Nancy Agmon-Levin1,3. 1. Clinical Immunology, Angioedema and Allergy Unit, The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel. 2. Department of Internal Medicine "C", Shamir Medical Center, Zerifin, Israel. 3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 4. Hematology Institute and Blood Bank, Meir Medical Center, Kfar Saba, Israel. 5. The National Hemophilia Center and Thrombosis Unit, Amalia Biron Research Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel Hashomer, Israel.
Abstract
Introduction: Primary obstetric antiphospholipid syndrome (OAPS) is defined by specific morbidities and/or losses of pregnancy in the presence of persistent antiphospholipid antibodies (aPL). This variant of APS is usually treated during pregnancy and the post-partum period. Data on occurrence of thrombotic event during long term follow-up of OAPS patients is limited. Methods: A multi-centre retrospectively cohort of female patients with primary APS (pAPS) was assembled during 2004-2019. Patients were grouped according to disease presentation as pure OAPS or thrombotic APS (tAPS) for those presenting with thrombosis. Clinical and serological data were compared between groups. Results: Of 219 pAPS female patients 67 (30.6%) were diagnosed with OAPS and 152 (69.4%) with tAPS. During >10 years of follow-up 24/67 (35.8%) OAPS and 71/152 (50%) tAPS suffered a new thrombotic event (p = 0.06), while obstetric morbidity was more likely in the OAPS group (31.3 vs. 10.5%, p < 0.001) respectively. Among patients with OAPS at presentation heart valve disease and the presence of ANA were related to thrombosis following diagnosis (25 vs. 4.7%, p = 0.02; and 45.8 vs. 20.8%, p = 0.04 respectively). Conclusion: Thrombotic event following diagnosis were common among female patients with pAPS regardless of disease presentation. Heart valve disease and ANA positivity may be risk factors for thrombosis during follow-up of patients presenting with pure OAPS.
Introduction: Primary obstetric antiphospholipid syndrome (OAPS) is defined by specific morbidities and/or losses of pregnancy in the presence of persistent antiphospholipid antibodies (aPL). This variant of APS is usually treated during pregnancy and the post-partum period. Data on occurrence of thrombotic event during long term follow-up of OAPS patients is limited. Methods: A multi-centre retrospectively cohort of female patients with primary APS (pAPS) was assembled during 2004-2019. Patients were grouped according to disease presentation as pure OAPS or thrombotic APS (tAPS) for those presenting with thrombosis. Clinical and serological data were compared between groups. Results: Of 219 pAPS female patients 67 (30.6%) were diagnosed with OAPS and 152 (69.4%) with tAPS. During >10 years of follow-up 24/67 (35.8%) OAPS and 71/152 (50%) tAPS suffered a new thrombotic event (p = 0.06), while obstetric morbidity was more likely in the OAPS group (31.3 vs. 10.5%, p < 0.001) respectively. Among patients with OAPS at presentation heart valve disease and the presence of ANA were related to thrombosis following diagnosis (25 vs. 4.7%, p = 0.02; and 45.8 vs. 20.8%, p = 0.04 respectively). Conclusion: Thrombotic event following diagnosis were common among female patients with pAPS regardless of disease presentation. Heart valve disease and ANA positivity may be risk factors for thrombosis during follow-up of patients presenting with pure OAPS.
Authors: M Radin; K Schreiber; P Costanzo; I Cecchi; D Roccatello; S Baldovino; M Bazzan; M J Cuadrado; S Sciascia Journal: Int J Cardiol Date: 2017-03-24 Impact factor: 4.164
Authors: G R de Jesús; S Sciascia; D Andrade; M Barbhaiya; M Tektonidou; A Banzato; V Pengo; L Ji; P L Meroni; A Ugarte; H Cohen; D W Branch; L Andreoli; H M Belmont; P R Fortin; M Petri; E Rodriguez; R Cervera; J S Knight; T Atsumi; R Willis; I S Nascimento; R Rosa; D Erkan; R A Levy Journal: BJOG Date: 2018-10-24 Impact factor: 6.531
Authors: L Andreoli; G K Bertsias; N Agmon-Levin; S Brown; R Cervera; N Costedoat-Chalumeau; A Doria; R Fischer-Betz; F Forger; M F Moraes-Fontes; M Khamashta; J King; A Lojacono; F Marchiori; P L Meroni; M Mosca; M Motta; M Ostensen; C Pamfil; L Raio; M Schneider; E Svenungsson; M Tektonidou; S Yavuz; D Boumpas; A Tincani Journal: Ann Rheum Dis Date: 2016-07-25 Impact factor: 19.103