Morbidity, mortality, and organ damage in patients with antiphospholipid syndrome.
| Autor: | Grika EP; Department of Pathophysiology, School of Medicine, National University of Athens, Athens, Greece., Ziakas PD, Zintzaras E, Moutsopoulos HM, Vlachoyiannopoulos PG |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of rheumatology [J Rheumatol] 2012 Mar; Vol. 39 (3), pp. 516-23. Date of Electronic Publication: 2012 Jan 15. |
| DOI: | 10.3899/jrheum.110800 |
| Abstrakt: | Objective: To describe morbidity, organ damage, mortality, and cause of death in patients with antiphospholipid syndrome (APS). Methods: Descriptive analysis of 135 patients. Patients were clustered according to initial event: arterial thrombosis including stroke (AT; n = 46), venous thrombosis including pulmonary emboli (VT; n = 53), or pregnancy morbidity (PM; n = 36). Disease progression according to initial event and prevalence of organ damage was observed. Results: APS occurs among young individuals (mean age 33.3 ± 11.9 yrs). One-third of the patients have APS secondary to systemic lupus erythematosus (SLE) or SLE-like disease. A broad spectrum of clinical manifestations mark the disease onset even before diagnosis. The pattern of initial presentation is preserved with regard to second event; VT is followed by VT (84%), AT is followed by AT (95%), and PM is followed by PM (88.9%). The highest morbidity is attributed to neurologic damage. PM is more likely to be followed by a second event, yet is associated with less organ damage than AT and VT. After a mean followup of 7.55 years, 29% of patients experienced organ damage and 5 died, with Systemic Lupus International Collaborating Clinics score associated with increased mortality (HR 1.31, 95% CI 1.07-1.60, p = 0.01, per 1-unit increase); hematological malignancies occurred in 2 patients after a cumulative followup of 1020 person-years. Coexistent SLE adds significant damage in patients with APS. Conclusion: APS is a disease of young individuals, who experience increased morbidity. Neurologic damage is the most common cause of morbidity. AT at presentation as well as coexistent SLE are associated with poor outcome. |
| Databáze: | MEDLINE |
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