Antiphospholipid syndrome – diagnosis and treatment

Česká verzia

Authors: A. Buliková; M. Penka
Authors place of work: Oddělení klinické hematologie FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Miroslav Penka, CSc.
Published in the journal: Vnitř Lék 2005; 91(7 a 8): 809-817
Category: 128th Internal Medicine Day - 21rd Vanysek's Day Brno 2005

Summary

Antiphospoholid syndrome is the most common form of acquired thrombophilia. It can cause significant morbidity and even mortality. Any organ system and any size of vessel can be affected during clinical course of the disease. Therefore, the antiphospholipid syndrome can manifest itself in a wide variety of clinical features. Despite advances in the understanding of the pathogenesis of antiphospholipid antibodies impact on their target structures, the mainstay of management is still anticoagulation. In this review, we focused on diagnostic procedure in patients with antiphospholipid antibodies and we summarised therapeutic approaches.

Key words:
antiphospholipid syndrome – diagnostic procedure – treatment

Zdroje

1. Arnout J, Vermylen J. Current status and implications of autoimmune antiphospholipid antibodies in relation to thrombotic disease. J Tromb Haemost 2003; 1: 931–942.

2. Arnout J, Jankowski M. Antiphospholipid syndrome. Hematology J 2004; 5: S1–S5.

3. Roubey RAS. Mechanisms of autoantibody-mediated thrombosis. Lupus 1998; 7: 114–119.

4. de Groot PG, Horbach DA, Derksen RHWM. Protein C and other cofactor involved in the binding of antiphospholipid antibodies: relation to the pathogenesis of thrombosis. Lupus 1996; 5: 488–493.

5. Esmon LN, Smirnov MD, Esmon CHT. Thrombogenic mechanisms of antiphospholipid antibodies. Thromb Haemost 1997; 78: 79–82.

6. Adams MJ, Donohoe S, Mackie IJ et al. Anti–tissue factor pathway activity in patients with primary antiphospholipid syndrome. British J Haematol 2001; 114: 375–379.

7. Joseph EJ, Harrison P, Mackie IJ et al. Increased circulation platelet-leukocyte and platelet activation in patients with antiphospholipid syndrome, systemic lupus erythematosus and rheumatoid arthritis. British J Hematol 2001; 115: 451–459.

8. Hill MB, Phipps JL, Hughes P et al. Anti-endothelial cell antibodies in primary antiphospholipid syndrome and SLE: patterns of reactivity with membrane antigens on microvascular and umbilical venous cell membranes. British J Haematol 1998; 103: 416–421.

9. Cuadrado MJ, López–Pedrera Ch, Khamashta MA et al. Thrombosis in primary antiphospholipid syndrome: a pivotal role for monocyte tissue factor expression. Arthritis Rheum 1997; 40: 834–841.

10. Petri M. Epidemiology of the antiphospholipid syndrome. J Autoimmunity 2000; 15: 145–151.

11. Buliková A, Matýšková M, Zavřelová J et al. Antiphosholipid antibodies in blood donors. Haemostasis 1998; Suppl 2: 460.

12. Wilson WA, Gharavi AE, Koike T et al. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome. Arthritis Rheumat 1999; 42: 1309–1311.

13. Galli M, Luciani D, Bertolini G et al. Anti-β₂-glykoprotein I, antiprothrombin antibodies, and the risk of thrombosis in the antiphospholipid syndrome. Blood 2003; 102: 2717–2723.

14. Arnout J. ISTH scientific standardisation subcommittee lupus anticoagulants/phospholipid dependent antibodies. International society of thrombosis and haemostasis. Boston: July 2002.

15. Vincent T, Mackworht-Young C. The primary antiphospholipid syndrome. In Khamashta MA. Hughes Syndrome. London: Springer Verlag 2000: 111–126.

16. Piette JC, Wechsler B, Frances C et al. Exclusion criteria for primary antiphospholipid syndrome. J Rheumatol 1993; 20: 1802–1804.

17. Levine JS, Branch DW, Rauch J. The antiphospholipid syndrome. N Engl J Med. 2002; 346: 752–763.

18. Finazzi G, Brancaccio V, Moia M et al. Natural history risk and risk factors in 360 patients with antiphospholipid antibodies. A four year prospect study forms the Italian registry. Am J Med 1996; 100: 530–536.

19. Battagliotti CA. Skin Manifestation of the antiphospholipid antibody syndrome. In Khamashta MA. Hughes Syndrome. London: Springer Verlag 2000: 59–69.

20. Navarrete MG, Brey RL, Levine SR Cerebral disease in the antiphospholipid syndrome. In: Khamashta MA. Hughes Syndrome. London: Springer Verlag 2000: 43–58.

21. Bray RL. Differential diagnosis of central nervous system manifestation of the antiphospholipid antibody syndrome: J Autoimmunity 2000; 15: 133–138.

22. Cervera R. Recent advances in antiphospholipid antibody-related valvulopathies. J Autoimmunity 2000; 15: 123–125.

23. Levy RA. Clinical manifestations of the aPL syndrome. Lupus 1996; 5: 393–397.

24. Font J, Cervera R. Cardiac manifestation in the antiphospholipid syndrome. In: Khamashta MA. Hughes Syndrome. London: Springer Verlag 2000: 32–42.

25. Nochy D, Daugas E, Huong DLT et al. Kidney involvement in the antiphospholipid syndrome. J Autoimmunity 2000; 15, 127–132.

26. Amigo MC, García-Torres R. Kidney disease in antiphosphopipid syndrome. In Khamashta MA. Huges Syndrome 2000; London: Springer Verlag 2000: 70–81.

27. Cervera R, Garcia-Carrasco M, Asherson RA. Pulmonary manifestation in the antiphospholipid syndrome. In Asherson RA, Cervera R, Piette JCh et al. The Antiphospholipid Syndrome. Boca

Raton: CRC Press 1996: 161–167.

28. Cervera R, Piette JCh, Font J at al. Euro-phospholipid project group. Antiphospholipid syndrome: Clinical and immunologic manifestation and patterns of disease expression in a cohort of 1000 patients. Arthritis Rheum 2002; 46: 1019.

29. Levine SR, Crofts JW, Lesser GR et al. Visual symptoms associated with the presence of a lupus anticoagulant. Ophthalmology 1988; 95: 686–692.

30. Asherson RA. Adrenal, hepatic, and other intraabdominal manifestation in the antiphospholipid syndrome. In: Asherson RA, Cervera R, Piette JCh et al. The Antiphospholipid Syndrome. Boca Raton: CRC Press 1996: 183–191.

31. Hughes GRV. Of the beaten tracks: A clinician’s view. In: Khamashta MA. Huges Syndrome. London: Springer-Verlag 2000: 105–110.

32. Montecucco C, Caporali R. Hemocytopenias in antiphospholipid syndrome. In: Khamashta MA. Huges Syndrome. London: Springer–Verlag 2000: 20–31.

33. Galli M, Finazzi G, Duca F et al. The G1691→A mutation of factor V, but not the G20210→A mutation of factor II or the C677→T mutation of methylentetrahydrofolate reductase genes, is associated with venous thrombosis in patients with lupus anticoagulants. British J Haematol 2000; 108: 865–870.

34. Galli M, Barbui T. Management of thrombocytopenia in Hughes Syndrome. In Khamashta MA. Hughes Syndrome. London: Springer-Verlag 2000: 408–418.

35. Triplett DA. Use of the dilute Russell viper venom time (dRVVT): its importance and pitfalls. J Autoimmunity 2000; 15: 173–178.

36. Mackie IJ, Donohoe S, Machin SJ. Lupus anticoagulant measurement. In Khamashta MA. Hughes Syndrome. London: Springer-Verlag 2000: 214–224.

37. Khamashta MA. Primary prevention of thrombosis in subjects with positive antiphospholipid antibodies. J Autoimmunity 2000; 15: 249–253.

38. Öztürk MA, Haznedaroglu IC, Turgut M et al. Current debates in antiphospholipid syndrome: The acquired antibody-mediated thrombophilia. Clin Appl Tromb/Hemost 2004; 10: 89–126.

39. Erkan D, Merril JT, Yazici Y et al. High thrombosis rate after fetal loss in antiphospholipid syndrome: Effective prophylaxis with aspirin. Arthritis Rheumat 2001; 44: 1466–1467.

40. Erkan D, Yazici Y, Harrison M et al. APLASA study: primary thrombosis prevention in asymptomatic antiphospholipid antibody (aPL) patients with low-dose aspirin. Lupus 2004; 11: 573.

41. Roubey R. Treatment of the antiphospholipid syndrome. Curr Opin Rheumatol 2002; 14: 238–242.

42. Khamashta MA, Cuadrado MJ, Mujic F et al. The management of thrombosis in the antiphospholipid-antibody syndrome. N Engl J Med 1995; 332: 993–997.

43. Ruiz-Irastorza G, Khamashta MA, Hunt BJ et al. Bleeding and recurrent thrombosis in definite antiphospholipid syndrome: analysis of a series of 66 patients treated with oral anticoagulation to a target international normalized ratio of 3,5. Arch Intern Med 2002; 162: 1164–1169.

44. Crowther MA, Ginsberg JS, Julian J et al. A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome. N Engl J Med 2003; 349: 1133–1138.

45. Finazzi G, Marchioli R, Barbui I. A randomized clinical trial of oral anticoagulant therapy in patients with the antiphospholipid syndrome. The WAPS study. J Tromb Haemost 2003; Suppl 1: Abstract OC 365.

46. APASS Investigators. Antiphospholipid antibodies and subsequent trombo-occlusive events in patients with ischemic stroke. JAMA 2004; 291: 576–584.

47. Khamashta MA. Management of thrombosis in the antiphospholipid syndrome. In Khamashta MA. Hughes Syndrome. London: Springer-Verlag 2000: 391–396.

48. Asherson RA, Cervera R, de Groot PG et al. Catastrophic antiphospholipid syndrome Registry Project Groop: Catastrophic antiphospholipid syndrome: International consensus statement on classification criteria and treatment guidelines. Lupus 2003; 12: 530.

49. Ferrari DE, Swerlic R, Casper K et al. Fluvastatin inhibits up-regulation of tissue factor expression by antiphospholipid antibodies on endothelial cells. J Tromb Haemost 2004; 2: 1558–1563.

50. Bick RL. Antiphospholipid thrombosis syndromes. Clin Appl Tromb Haemost 2001; 7: 241–258.