RESUMEN
El síndrome de anticuerpos antifosfolipídicos es una enfermedad autoinmune no inflamatoria, caracterizada por eventos trombóticos recurrentes y/o complicaciones obstétricas, asociados a la presencia de anticuerpos antifosfolipídicos circulantes: anticuerpos anticardiolipina, anti-β2 glucoproteína-i y/o anticoagulante lúpico. Los anticuerpos antifosfolipídicos son un grupo heterogéneo de autoanticuerpos asociados con morbilidad obstétrica, como pérdida gestacional recurrente, muerte fetal, parto pretérmino asociado a insuficiencia placentaria como enfermedad hipertensiva del embarazo y/o restricción del crecimiento intrauterino. Los procesos fisiopatológicos relacionados con la morbilidad obstétrica no se han comprendido del todo, involucrándose múltiples eventos inmunológicos, entre ellos los inflamatorios, la activación del complemento, el desbalance de los factores angiogénicos y, en alguna proporción de los casos, se ha demostrado trombosis e infarto. Debido a la controversia en los criterios clínicos y de laboratorio, así como a la repercusión en la mejora de los resultados perinatales en pacientes que inician tratamiento, decidimos llevar a cabo esta revisión sobre los conceptos de síndrome de anticuerpos antifosfolipídico relacionado con complicaciones obstétricas y síndrome de anticuerpos antifosfolipídico seronegativo, así como su manejo en obstetricia (AU)
Antiphospholipid antibody syndrome is a non-inflammatory autoimmune disease characterized by recurrent thrombotic events and/or obstetric complications associated with the presence of circulating antiphospholipid antibodies (anticardiolipin antibodies, anti-β2 glycoprotein-i antibodies, and/or lupus anticoagulant. Antiphospholipid antibodies are a heterogeneous group of autoantibodies associated with recurrent miscarriage, stillbirth, fetal growth restriction and premature birth. The diversity of the features of the proposed placental antiphospholipid antibodies fingerprint suggests that several disease processes may occur in the placentae of women with antiphospholipid antibody syndrome in the form of immune responses: inflammatory events, complement activation, angiogenic imbalance and, less commonly, thrombosis and infarction. Because of the disparity between clinical and laboratory criteria, and the impact on perinatal outcome in patients starting treatment, we reviewed the aspects of antiphospholipid antibody syndrome related to obstetric complications and seronegative antiphospholipid antibody syndrome, and their treatment in obstetrics (AU)
Asunto(s)
Humanos , Masculino , Femenino , Síndrome Antifosfolípido/complicaciones , Síndrome Antifosfolípido/diagnóstico , Síndrome Antifosfolípido/patología , Obstetricia/métodos , Complicaciones del Embarazo/diagnóstico , Atención Perinatal/métodos , Anticuerpos Anticardiolipina/análisis , Consenso , Conferencias de Consenso como Asunto , Factores de Riesgo , Muerte FetalRESUMEN
Antiphospholipid antibody syndrome is a non-inflammatory autoimmune disease characterized by recurrent thrombotic events and/or obstetric complications associated with the presence of circulating antiphospholipid antibodies (anticardiolipin antibodies, anti-ß2 glycoprotein-i antibodies, and/or lupus anticoagulant. Antiphospholipid antibodies are a heterogeneous group of autoantibodies associated with recurrent miscarriage, stillbirth, fetal growth restriction and premature birth. The diversity of the features of the proposed placental antiphospholipid antibodies fingerprint suggests that several disease processes may occur in the placentae of women with antiphospholipid antibody syndrome in the form of immune responses: inflammatory events, complement activation, angiogenic imbalance and, less commonly, thrombosis and infarction. Because of the disparity between clinical and laboratory criteria, and the impact on perinatal outcome in patients starting treatment, we reviewed the aspects of antiphospholipid antibody syndrome related to obstetric complications and seronegative antiphospholipid antibody syndrome, and their treatment in obstetrics.
Asunto(s)
Síndrome Antifosfolípido , Complicaciones del Embarazo , Síndrome Antifosfolípido/diagnóstico , Síndrome Antifosfolípido/fisiopatología , Síndrome Antifosfolípido/terapia , Femenino , Humanos , Embarazo , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/fisiopatología , Complicaciones del Embarazo/terapiaRESUMEN
BACKGROUND: The characteristics of the infiltrating lobular carcinoma of the breast are not clear, this is caused by special histological and biological features. OBJECTIVE: To identify the clinical stage and correlate it with the radiological and histological features of the disease to make an opportune diagnosis. PATIENTS AND METHODS: From January 1st, 2003 to July 31st, 2004 we identified 68 cases of infiltrating lobular carcinoma at the Luis Castelazo Ayala Hospital. The cases were classified by clinical, radiological and histological features. The results were expressed in media and standard deviation. The difference between the mixed and pure lobular carcinoma types were compared by chi-square test. RESULTS: From 68 patients, 31 had mixed lobular carcinoma, 20 pure, 12 were eliminated because the patient's records were not found and five because the definitive histological report was not lobular carcinoma. The median age for both groups was 50 years old. The most affected region was the upper one (> 80%). The hormonal receptor was more frequently expressed in the pure subtype (p < 0.04), this latter was associated to a delayed diagnosis (p < 0.03). Mammography was considered useful for diagnosis. CONCLUSIONS: The histological behavior of lobular carcinoma is related to non clear characteristics and to delayed diagnosis; however, with a careful evaluation these features can be recognized and make possible an opportune mammography.