scholarly journals Clinical case of rheumatoid arthritis with antiphospholipid antibody syndrome

2015 ◽  
Vol 6 (3) ◽  
pp. 70-78
Author(s):  
G. G Arabidze ◽  
A. V Shapchenko ◽  
O. V Muslimova ◽  
O. Yu Larina ◽  
A. M Sorokoletov
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Case ◽  
Patient Treatment ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Vein Thrombosis ◽  
Adrenal Pheochromocytoma ◽  
Modern Classification ◽  
Rheumatoid Polyarthritis ◽  
Deep Vein

The article presents a clinical case of development of secondary antiphospholipid syndrome (APS) with early active rheumatoid polyarthritis, complication in the form of acute deep vein thrombosis of forearm on the left and chronic left vein thrombosis of the lower extremity. Patient treatment with methotrexate has developed an infectious complication and resulting in the need to go to therapy of leflunomide. This therapy have positive effect. In a survey of the patient revealed a rare form of adrenal pheochromocytoma confirmed by computed tomography and measurements of plasma normetanephrine, but not accompanied an increase of blood pressure. This article discusses the modern classification of APS, pathogenesis, clinical and laboratory diagnostic criteria, methods of therapy as rheumatoid arthritis, and APS.

scholarly journals Thrombosis with Thrombocytopenia - A Vascular Paradox

2020 ◽  
Vol 7 (51) ◽  
pp. 3110-3116
Author(s):  
Veena Nanjappa ◽  
Lachikarathman Devegowda ◽  
Abhishek Rathore ◽  
Sadanand K.S ◽  
Manjunath Cholenahally Nanjappa
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Hypertension ◽  
Deep Vein Thrombosis ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Bleeding Tendency ◽  
Normal Peripheral Blood ◽  
Vein Thrombosis ◽  
Keywords Thrombosis ◽  
Deep Vein

BACKGROUND Thrombosis associated with thrombocytopenia is a vascular paradox which we seldom encounter in our clinical practice. We hereby describe four real world clinical situations and their therapeutic management. Since there are no guidelines regarding this subset, most of the treatment is based on few anecdotal reports and consensus data. Hence, we have reviewed the literature to throw light on some pertinent clinically relevant questions. Our objective is to describe and discuss the probable reasons of vascular paradox and its management. METHODS It is a descriptive study of four cases collected over one-year period including patients of thrombosis with thrombocytopenia. RESULTS In the first case, the patient had pulmonary embolism as a presenting manifestation of leukaemia. Only 5 % cases of AML-M3 sub type acute promyelocytic leukaemia present with normal peripheral blood smear. Patient had thrombocytopenia with deep vein thrombosis and pulmonary embolism. In the second case, secondary antiphospholipid antibody syndrome (APLS) presented with ilio-femoral deep vein thrombosis associated with thrombocytopenia and bleeding tendency. In the third case, antiphospholipid antibody syndrome with thrombocytopenia was associated with severe pulmonary hypertension and deep vein thrombosis. In the fourth case, patient presented with non-ST elevation myocardial infarction (NSTEMI) with thrombocytopenia. He was diagnosed with idiopathic thrombocytopenic purpura. He had angiographic evidence of critical triple vessel disease. He was treated with coronary bypass surgery after initiating treatment with oral eltrombopag and steroids. CONCLUSIONS We have highlighted four clinical situations ranging from frank malignancy to pure vascular pathology, where we have encountered and tackled the vascular paradox of ‘thrombosis and thrombocytopenia’ and reviewed the literature pertaining to these case scenarios. KEYWORDS Thrombosis with Thrombocytopenia, APLS, AML-M3, Pulmonary Hypertension, ITP

scholarly journals Primary Antiphospholipid Antibody Syndrome Presenting as Recurrent Deep Vein Thrombosis

2014 ◽  
Vol 13 (2) ◽  
pp. 218-220
Author(s):  
Abdul Mahid Khan ◽  
Hasina Banoo
Keyword(s):  
Deep Vein Thrombosis ◽  
Medical Science ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Vein Thrombosis ◽  
Recurrent Deep Vein Thrombosis ◽  
Deep Vein

DOI: http://dx.doi.org/10.3329/bjms.v13i2.18307 Bangladesh Journal of Medical Science Vol.13(2) 2014 p.218-220

IgA Anticardiolipin Antibodies – Relation with other Antiphospholipid Antibodies and Clinical Significance

1998 ◽  
Vol 79 (02) ◽  
pp. 282-285 ◽  
Author(s):  
Josep Ordi-Ros ◽  
Francesc Monegal-Ferran ◽  
Nuria Martinez ◽  
Fina Cortes-Hernandez ◽  
Miquel Vilardell-Tarres ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Antiphospholipid Antibodies ◽  
Fetal Loss ◽  
Cross Sectional Study ◽  
Anticardiolipin Antibodies ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Serum Samples ◽  
Cross Sectional ◽  
Vein Thrombosis

SummaryObjective: To evaluate the usefulness of IgA antiphospholipid antibodies as markers of thrombosis and/or antiphospholipid antibody syndrome. Patients and Methods: A cross-sectional study design in a tertiary, university-based, autoimmune reference hospital. Seven-hundred ninety-five patients classified into five different groups – autoimmune diseases (255), deep vein thrombosis (153), transitory ischemic attacks (108), obstetric complications (196), infectious diseases (83) and controls (81) – were tested for IgA, IgG and IgM aPL, and lupus anticoagulant. Plasma and serum samples were drawn for detection of aPL using an internationally standardized ELISA method and LA was carried out using coagulometric assays. Results: True IgA aPL were found only in two patients with systemic lupus erythematosus; these patients were also positive to IgG aPL. Conclusion: The incidence of true positivity to IgA anticardiolipin antibodies is extremely low. Their determination was not helpful in diagnosing the antiphospholipid syndrome or in explaining thrombotic events or aPL related manifestations – fetal loss – in the groups studied.

scholarly journals Incidence of inpatient venous thromboembolism in treated patients with rheumatoid arthritis and the association with switching biologic or targeted synthetic disease-modifying antirheumatic drugs (DMARDs) in the real-world setting

RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e001013 ◽  
Author(s):  
Huifang Liang ◽  
Raghava Danwada ◽  
Dianlin Guo ◽  
Jeffrey R Curtis ◽  
Ryan D Kilpatrick ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cox Regression ◽  
Incidence Rates ◽  
Disease Modifying Antirheumatic Drugs ◽  
Vein Thrombosis ◽  
Real World Setting ◽  
Increased Risk ◽  
Safety Studies ◽  
Unbiased Estimates ◽  
Deep Vein

ObjectivesTo assess incidence rates (IRs) of VTE in patients with rheumatoid arthritis (RA) on different DMARDs and DMARD switchers.MethodsAdults with RA on a DMARD between 2007 and 2017 were studied in a US claims database. Conventional synthetic DMARD (csDMARD) users, first biologic/targeted synthetic DMARD (b/tsDMARD) users and b/tsDMARD switchers (from a b/tsDMARD to another b/tsDMARD) were followed for inpatient VTE (pulmonary embolism (PE)/deep vein thrombosis (DVT)). Crude and adjusted IR and 95% CIs of VTE were estimated. HRs for VTE were estimated via Cox regression. VTE risk was also evaluated by number of switches between b/tsDMARDs and in patients without a VTE history.ResultsThe age and sex standardised IR (95% CI) of VTE (per 100 person-years) was 0.86 (0.70 to 1.03), 0.60 (0.52 to 0.68) and 0.58 (0.51 to 0.65) for b/tsDMARD switchers, first b/tsDMARD users and csDMARD users, respectively. After adjustment, b/tsDMARD switchers had an increased risk of VTE, compared with csDMARD users, HRadj (95% CI) being 1.36 (1.16 to 1.58), 1.36 (1.13 to 1.63) and 1.47 (1.18 to 1.83) for VTE, DVT and PE, respectively. Compared with first b/tsDMARD users, the HRadj (95% CI) for VTE was 1.35 (1.15 to 1.60) for first b/tsDMARD switchers and 1.48 (1.19 to 1.85) for second b/tsDMARD switchers.ConclusionsIn RA, b/tsDMARD switchers have a higher VTE risk compared with csDMARD users and first b/tsDMARD users. Switching b/tsDMARDs may be a proxy for higher disease severity or poorly controlled RA and an important confounder to consider in obtaining unbiased estimates of VTE risk in observational RA safety studies.

Antiphospholipid antibody profile: implications for the evaluation and management of patients

Lupus ◽  
2010 ◽  
Vol 19 (4) ◽  
pp. 432-435 ◽  
Author(s):  
A. Tincani ◽  
L. Andreoli ◽  
C. Casu ◽  
R. Cattaneo ◽  
P. Meroni
Keyword(s):  
Pregnancy Loss ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Diagnostic Value ◽  
Antiphospholipid Antibody ◽  
Vein Thrombosis ◽  
Glycoprotein I ◽  
Antibody Assays ◽  
Independent Risk Factors ◽  
Deep Vein

According to the classification criteria of antiphospholipid syndrome, lupus anticoagulant, anticardiolipin and anti-β2 glycoprotein I antibody assays are independent risk factors for the occurrence of vascular thrombosis and pregnancy loss. However, it is generally accepted that patients carrying multiple positivity have more a severe disease and higher recurrence rate despite treatment. On the other hand, the diagnostic value of a positive result in one only assay is more controversial, particularly in the presence of clinical manifestations such as deep vein thrombosis or early miscarriages, which are rather common in the general population. In this review we speculate on current and future strategies to interpret different antiphospholipid antibody profiles in the clinical practice. Lupus (2010) 19, 432—435.

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