Premium
Hospital based prospective longitudinal clinical and immunologic study of 179 patients of primary anti‐phospholipid syndrome
Author(s) -
Singh Nand K.,
Behera Dibya R.,
Agrawal Ankit,
Singh Mahendra Narayan,
Kumar Vikash,
Godhra Manoj,
Gupta Anurag,
Yadav Devesh P.,
Singh Usha,
Pandey Lakshmi Kant,
Matah Manjari
Publication year - 2013
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12150
Subject(s) - medicine , antiphospholipid syndrome , thrombosis , lupus anticoagulant , venous thrombosis , prospective cohort study , deep vein , gastroenterology , surgery
Aim To study the clinical and immunological features of primary antiphospholipid syndrome ( APS ), and to analyze the differences between primary APS and APS associated with autoimmune rheumatic disease ( ARD / APS ). Methods This prospective, longitudinal study, carried out from D ecember 2004 to J uly 2011 included 179 patients with primary APS and 52 patients of ARD / APS diagnosed as per modified 2006 S apporo's C riteria. Results Out of 179 patients of primary APS , 12 were male and 167 were female. The mean age at the time of study entry was 27 ± 4.33 years. Venous thrombosis was noted in 33 (18.43%) patients. Seventeen patients had deep vein thrombosis and 11 (7.19%) had cortical vein and/or cortical sinus thrombosis. Arterial thrombosis was noted in 19 (10.61%) patients, out of which nine had intracranial arterial thrombosis. Thirty‐two (17.85%) had recurrent early fetal losses (< 10 weeks) and 97 (54.18%) had late fetal loss (> 10 weeks). Immunoglobulin G (IgG) and IgM aCLA were present in 141 (78.77%) and 32 (17.87%) patients respectively, whereas lupus anticoagulant was present in 99 (55.3%) patients. In patients with bad obstetric outcome, lupus anticoagulant positivity was significantly more prevalent ( P < 0.05) than aCLA positivity. Both venous and arterial thrombosis were significantly more common ( P < 0.05) in ARD / APS . However, late fetal loss was significantly more prevalent ( P < 0.001) in primary APS. Conclusion Primary APS may lead to a variety of clinical manifestations due to venous and/or arterial thrombosis, which at times may be lethal. It is also an important cause of early and late pregnancy loss(es) and other pregnancy morbidities.