Clinical study and follow-up of 100 patients with the antiphospholipid syndrome
| Autor: | Joan Carles Reverter, Alfonso López-Soto, Gerard Espinosa, F. J. Muñoz-Rodriguez, Miguel Ingelmo, Antoni Ordinas, Richard Cervera, Joan Balasch, Josep Font, Dolors Tàssies, Francisco Carmona |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Anti-nuclear antibody Adolescent medicine.drug_class Gastroenterology Diagnosis Differential Rheumatology Antiphospholipid syndrome Pregnancy Internal medicine medicine Secondary Prevention Humans Aged Retrospective Studies Aspirin business.industry Anticoagulant Pregnancy Outcome Anticoagulants Retrospective cohort study Thrombosis Middle Aged medicine.disease Antiphospholipid Syndrome Thrombocytopenia Surgery Pregnancy Complications Anesthesiology and Pain Medicine Treatment Outcome Drug Therapy Combination Female Complication business Platelet Aggregation Inhibitors medicine.drug Follow-Up Studies |
| Zdroj: | Seminars in arthritis and rheumatism. 29(3) |
| ISSN: | 0049-0172 |
| Popis: | Objectives: To study the clinical characteristics at diagnosis and during follow-upof patients with the antiphospholipid syndrome (APS) and to analyze the influence of treatment on their outcome. Patients: One hundred patients with APS were included (86% female and 14%male; mean age, 36 years). Sixty-two percent had primary APS and 38% had APS associated with systemic lupus erythematosus (SLE). The median length of follow-up was 49 months. Results: Fifty-three percent of the patients had thromboses, 52% had thrombocytopenia, and 60% of the women had pregnancy losses. Patients with APS associated with SLE had a higher prevalence of hemolytic anemia ( P = .02), thrombocytopenia (platelet count lower than 100 × 10 9 /L) ( P = .004), antinuclear antibodies ( P = .0002), and low complement levels. Fifty-three percent of the patients with thrombosis had recurrent episodes (86% in the same site as the previous thrombotic event). Recurrences were observed in 19% of the episodes treated with long-term oral anticoagulation, in 42% treated prophylactically with aspirin, and in 91% in which anticoagulant/antiaggregant treatment was discontinued ( P = .0007). Multivariate analysis showed that prophylactic treatment and older age had an independent predictive value for rethrombosis. Prophylactic treatment during pregnancy (usually with aspirin) increased the live birth rate from 38% to 72% ( P = .0002). Conclusions: Patients with APS have a high risk of recurrent thromboses. Long-term oral anticoagulation seems to be the best prophylactic treatment to prevent recurrences. Prophylactic treatment with aspirin during pregnancy reduced the rate of miscarriages remarkably. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect