Antiphospholipid antibodies disappearance in primary antiphospholipid syndrome: Thrombosis recurrence.
Autoimmun Rev
; 16(4): 352-354, 2017 Apr.
Article
en En
| MEDLINE
| ID: mdl-28216071
ABSTRACT
OBJECTIVE:
To evaluate the clinical outcome after aPL (antiphospholipid antibodies) disappearance in primary APS patients.METHODS:
From a cohort of 70 patients with primary APS, we selected patients with positive aPL determinations at onset and ≥2 subsequent negative aPL determinations during the last 5years. To corroborate the immunologic profile, we determined IgG/IgM aCL antibodies, IgG/IgM antiß2GPl, anti-annexin A5 antibodies and lupus anticoagulant (LA). All patients continued treatment with oral anticoagulants. Clinical data and aPL determinations at onset/after disappearance were obtained. STATISTICALANALYSIS:
descriptive statistics and Kaplan-Meier analysis.RESULTS:
We found 24 patients with persistently negative aPL, including the last immunologic profile, 17 females, 7 males, mean age 51.7, disease evolution 16.3years, mean of 4 aPL previous positive determinations. aCL was positive at onset in 87.5%, 29% had double aPL positivity at onset (aCL/LA). Deep venous thrombosis (DVT) and ischemic stroke in 33% and pulmonary embolism in 12.5% were the most frequent manifestations at onset. INR range 2-3. Time with aPL positive 109.4±80.7months. After 60months of follow-up since aPL disappearance, 45.8% of patients presented thrombosis recurrence, DVT in 9 patients, ischemic stroke in 1, pulmonary artery hypertension in 1. Other non-thrombotic APS manifestations were chronic ulcers in lower extremities and severe thrombocytopenia.CONCLUSIONS:
This study suggest, that in primary APS, persistent negative aPL profile is not an indication to interrupt oral anticoagulant therapy. However, there is a subset of patients that remained asymptomatic. Other studies are necessary in order to elucidate this controversy.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Trombosis
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Síndrome Antifosfolípido
/
Anticuerpos Antifosfolípidos
Tipo de estudio:
Etiology_studies
/
Incidence_studies
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Observational_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
Autoimmun Rev
Asunto de la revista:
ALERGIA E IMUNOLOGIA
Año:
2017
Tipo del documento:
Article