Korean J Med.  1998 Sep;55(3):325-333.

Clinical Significance of Antiphospholipid Syndrome

• Lee WC
• Lee SB
• Kim YM
• Hong JH
• Seong EY
• Park SM
• Kwak IS
• Rha HY

Abstract

OBJECTIVES
Antiphospholipid syndrome (APS) is characterized by arterial or venous thrombosis, recurrent fetal loss, many neurological deficits, and presence of anticardiolipin antibody (ACA) or lupus anticoagulant (LA). This study was done to know the clinical and serological characteristics of antiphospholipid syndrome.
METHODS
Clinical and laboratory features of 18 patients with APS who had antiphopholipid antibodies and histories of obstetric events and thrombosis were studied.
RESULTS
Of the 18 patients, 4 were male, and 14 were female, and the ages ranged from 19 to 64 years. 11 patients were primary APS. 17 patients had ACAs: 11 had IgG ACA; 2 had IgM ACA; 3 had both IgG and IgM; 1 had both IgG and IgA; 1 patient had LA. Antinuclear antibodies were positive (>1:40) in 15 patients, and anti-ds-DNA (>1:10) were present in 8 patients. Hemolytic anemia was noted in 4 patients with positive in only direct Coomb's test, and all were secondary APS. Thrombocytopenia (<150,000/mm3) was observed in 14 patients, 9 patients ranged between 100,000/mm3 and 150,000/mm3. Initial presentation were deep vein thrombosis in 7 patients, pulmonary embolism in 3, arterial occlusion in 3, leg ulcer in 1, spontaneous abortion in 2, preeclampsia in 1, preterm labor in 1. Combined diseases were SLE, Sj gren syndrome, idiopathic thrombocytopenic purpura, hypertension. In 7 patients associated with cardiac abnormalities, 3 were mitral regurgitation, 4 were pericardial effusion, 1 was dilated cardiomyopathy. Venous thrombosis were present in 11 patients, 6 had deep vein thrombosis only, 3 had both deep vein thrombosis and pulmonary embolism. Arterial occlusion were present in 4 patients, 3 had small multiple cerebral infarction, 1 had right common femoral arterial occlusion. Obstetric complications were present 5 patients of 14 female patients: 3 had spontaneous abortion, preeclampsia was present in 1 and preterm labor was present in 1.
CONCLUSIONS
The clinical and serological features of APS in this study were similar to those of previous reports (Oeffinger et al.,1994: Edelman et al., 1995). Treatment with prednisolone, anticoagulants and antiplatelet agents was used. Of the 10 follow-up patients, none had recurrence of thrombotic events.

Keyword

Antiphospholipid syndrome; Anticardiolipin antibody; Lupus anticoagulant; Thrombosis; Spontaneous abortion; Thrombocytopenia

MeSH Terms

Abortion, Spontaneous
Anemia, Hemolytic
Antibodies
Antibodies, Anticardiolipin
Antibodies, Antinuclear
Anticoagulants
Antiphospholipid Syndrome*
Cardiomyopathy, Dilated
Cerebral Infarction
Coombs Test
Female
Follow-Up Studies
Humans
Hypertension
Immunoglobulin A
Immunoglobulin G
Immunoglobulin M
Leg Ulcer
Lupus Coagulation Inhibitor
Male
Mitral Valve Insufficiency
Obstetric Labor, Premature
Pericardial Effusion
Platelet Aggregation Inhibitors
Pre-Eclampsia
Prednisolone
Pregnancy
Pulmonary Embolism
Purpura, Thrombocytopenic, Idiopathic
Recurrence
Thrombocytopenia
Thrombosis
Venous Thrombosis
Antibodies
Antibodies, Anticardiolipin
Antibodies, Antinuclear
Anticoagulants
Immunoglobulin A
Immunoglobulin G
Immunoglobulin M
Lupus Coagulation Inhibitor
Platelet Aggregation Inhibitors
Prednisolone