Pathogenesis, Diagnosis and Management of Obstetric Antiphospholipid Syndrome: A Comprehensive Review
| Autor: | Enrique Esteve-Valverde, Ariadna Anunciación-Llunell, Jaume Alijotas-Reig, José Pardos-Gea, Francesc A. Miro-Mur, Joana Rita Marques Soares |
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| Přispěvatelé: | Institut Català de la Salut, [Alijotas-Reig J] Unitat de Recerca de Malalties Autoimmunes Sistèmiques, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Unitat de Malalties Autoimmunes Sistèmiques, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Esteve-Valverde E] Department of Internal Medicine, Althaia Xarxa Assistencial, Manresa, Spain. [Anunciación-Llunell A, Miró-Mur F] Unitat de Recerca de Malalties Autoimmunes Sistèmiques, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. [Marques-Soares J, Pardos-Gea J] Unitat de Recerca de Malalties Autoimmunes Sistèmiques, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Unitat de Malalties Autoimmunes Sistèmiques, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
enfermedades del sistema inmune::enfermedades autoinmunes::síndrome antifosfolípido [ENFERMEDADES]
diagnosis pathogenesis Otros calificadores::/diagnóstico [Otros calificadores] non-criteria antiphospholipid antibodies Embaràs - Complicacions General Medicine obstetric antiphospholipid syndrome Immune System Diseases::Autoimmune Diseases::Antiphospholipid Syndrome [DISEASES] Síndrome antifosfolipídica - Diagnòstic Other subheadings::/diagnosis [Other subheadings] antiphospholipid antibody Medicine Immunoglobulines management |
| Zdroj: | Journal of Clinical Medicine, Vol 11, Iss 675, p 675 (2022) Scientia |
| ISSN: | 2077-0383 |
| Popis: | Diagnosis; Obstetric antiphospholipid syndrome; Pathogenesis Diagnóstico; Síndrome antifosfolípido obstétrico; Patogénesis Diagnòstic; Síndrome antifosfolípid obstètric; Patogènesi Antiphospholipid syndrome is an autoimmune disorder characterized by vascular thrombosis and/or pregnancy morbidity associated with persistent antiphospholipid antibody positivity. Cases fulfilling the Sydney criteria for obstetric morbidity with no previous thrombosis are known as obstetric antiphospholipid syndrome (OAPS). OAPS is the most identified cause of recurrent pregnancy loss and late-pregnancy morbidity related to placental injury. Cases with incomplete clinical or laboratory data are classified as obstetric morbidity APS (OMAPS) and non-criteria OAPS (NC-OAPS), respectively. Inflammatory and thrombotic mechanisms are involved in the pathophysiology of OAPS. Trophoblasts, endothelium, platelets and innate immune cells are key cellular players. Complement activation plays a crucial pathogenic role. Secondary placental thrombosis appears by clot formation in response to tissue factor activation. New risk assessment tools could improve the prediction of obstetric complication recurrences or thromboses. The standard-of-care treatment consists of low-dose aspirin and prophylactic low molecular weight heparin. In refractory cases, the addition of hydroxychloroquine, low-dose prednisone or IVIG improve pregnancy outcomes. Statins and eculizumab are currently being tested for treating selected OAPS women. Finally, we revisited recent insights and concerns about the pathophysiology, diagnosis and management of OAPS. This study was supported, in part, by a grant from the Ona Futura Foundation, Balearic Islands (ONA-JAR-2021), Spain and from the International Center for Human Assisted Reproduction of Barcelona (GRAVIDA, GRA-JAR-2021), Spain. |
| Databáze: | OpenAIRE |
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