Antiphospholipid syndrome

Karen Schreiber; Savino Sciascia; Philip G de Groot; Katrien Devreese; Soren Jacobsen; Guillermo Ruiz-Irastorza; Jane E Salmon; Yehuda Shoenfeld; Ora Shovman; Beverley J Hunt

doi:10.1038/nrdp.2017.103

Antiphospholipid syndrome

Karen Schreiber, Savino Sciascia, Philip G de Groot, Katrien Devreese, Soren Jacobsen, Guillermo Ruiz-Irastorza, Jane E Salmon, Yehuda Shoenfeld, Ora Shovman, Beverley J Hunt

Institut for Klinisk Medicin

105 Citationer (Scopus)

Abstract

Antiphospholipid syndrome (APS) is an autoimmune disease characterized by the presence of antiphospholipid antibodies, such as lupus anticoagulant, anticardiolipin antibodies and anti-β2-glycoprotein 1 antibodies. APS can present with a variety of clinical phenotypes, including thrombosis in the veins, arteries and microvasculature as well as obstetrical complications. The pathophysiological hallmark is thrombosis, but other factors such as complement activation might be important. Prevention of thrombotic manifestations associated with APS includes lifestyle changes and, in individuals at high risk, low-dose aspirin. Prevention and treatment of thrombotic events are dependent mainly on the use of vitamin K antagonists. Immunosuppression and anticomplement therapy have been used anecdotally but have not been adequately tested. Pregnancy morbidity includes unexplained recurrent early miscarriage, fetal death and late obstetrical manifestation such as pre-eclampsia, premature birth or fetal growth restriction associated with placental insufficiency. Current treatment to prevent obstetrical morbidity is based on low-dose aspirin and/or low-molecular-weight heparin and has improved pregnancy outcomes to achieve successful live birth in >70% of pregnancies. Although hydroxychloroquine and pravastatin might further improve pregnancy outcomes, prospective clinical trials are required to confirm these findings.

Originalsprog	Engelsk
Artikelnummer	17103
Tidsskrift	Nature Reviews Disease Primers
Vol/bind	4
Antal sider	20
ISSN	2056-676X
DOI	https://doi.org/10.1038/nrdp.2017.103
Status	Udgivet - 11 jan. 2018

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10.1038/nrdp.2017.103

Citationsformater

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title = "Antiphospholipid syndrome",

abstract = "Antiphospholipid syndrome (APS) is an autoimmune disease characterized by the presence of antiphospholipid antibodies, such as lupus anticoagulant, anticardiolipin antibodies and anti-β2-glycoprotein 1 antibodies. APS can present with a variety of clinical phenotypes, including thrombosis in the veins, arteries and microvasculature as well as obstetrical complications. The pathophysiological hallmark is thrombosis, but other factors such as complement activation might be important. Prevention of thrombotic manifestations associated with APS includes lifestyle changes and, in individuals at high risk, low-dose aspirin. Prevention and treatment of thrombotic events are dependent mainly on the use of vitamin K antagonists. Immunosuppression and anticomplement therapy have been used anecdotally but have not been adequately tested. Pregnancy morbidity includes unexplained recurrent early miscarriage, fetal death and late obstetrical manifestation such as pre-eclampsia, premature birth or fetal growth restriction associated with placental insufficiency. Current treatment to prevent obstetrical morbidity is based on low-dose aspirin and/or low-molecular-weight heparin and has improved pregnancy outcomes to achieve successful live birth in >70% of pregnancies. Although hydroxychloroquine and pravastatin might further improve pregnancy outcomes, prospective clinical trials are required to confirm these findings.",

author = "Karen Schreiber and Savino Sciascia and {de Groot}, {Philip G} and Katrien Devreese and Soren Jacobsen and Guillermo Ruiz-Irastorza and Salmon, {Jane E} and Yehuda Shoenfeld and Ora Shovman and Hunt, {Beverley J}",

year = "2018",

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T1 - Antiphospholipid syndrome

AU - Schreiber, Karen

AU - Sciascia, Savino

AU - de Groot, Philip G

AU - Devreese, Katrien

AU - Jacobsen, Soren

AU - Ruiz-Irastorza, Guillermo

AU - Salmon, Jane E

AU - Shoenfeld, Yehuda

AU - Shovman, Ora

AU - Hunt, Beverley J

PY - 2018/1/11

Y1 - 2018/1/11

N2 - Antiphospholipid syndrome (APS) is an autoimmune disease characterized by the presence of antiphospholipid antibodies, such as lupus anticoagulant, anticardiolipin antibodies and anti-β2-glycoprotein 1 antibodies. APS can present with a variety of clinical phenotypes, including thrombosis in the veins, arteries and microvasculature as well as obstetrical complications. The pathophysiological hallmark is thrombosis, but other factors such as complement activation might be important. Prevention of thrombotic manifestations associated with APS includes lifestyle changes and, in individuals at high risk, low-dose aspirin. Prevention and treatment of thrombotic events are dependent mainly on the use of vitamin K antagonists. Immunosuppression and anticomplement therapy have been used anecdotally but have not been adequately tested. Pregnancy morbidity includes unexplained recurrent early miscarriage, fetal death and late obstetrical manifestation such as pre-eclampsia, premature birth or fetal growth restriction associated with placental insufficiency. Current treatment to prevent obstetrical morbidity is based on low-dose aspirin and/or low-molecular-weight heparin and has improved pregnancy outcomes to achieve successful live birth in >70% of pregnancies. Although hydroxychloroquine and pravastatin might further improve pregnancy outcomes, prospective clinical trials are required to confirm these findings.

AB - Antiphospholipid syndrome (APS) is an autoimmune disease characterized by the presence of antiphospholipid antibodies, such as lupus anticoagulant, anticardiolipin antibodies and anti-β2-glycoprotein 1 antibodies. APS can present with a variety of clinical phenotypes, including thrombosis in the veins, arteries and microvasculature as well as obstetrical complications. The pathophysiological hallmark is thrombosis, but other factors such as complement activation might be important. Prevention of thrombotic manifestations associated with APS includes lifestyle changes and, in individuals at high risk, low-dose aspirin. Prevention and treatment of thrombotic events are dependent mainly on the use of vitamin K antagonists. Immunosuppression and anticomplement therapy have been used anecdotally but have not been adequately tested. Pregnancy morbidity includes unexplained recurrent early miscarriage, fetal death and late obstetrical manifestation such as pre-eclampsia, premature birth or fetal growth restriction associated with placental insufficiency. Current treatment to prevent obstetrical morbidity is based on low-dose aspirin and/or low-molecular-weight heparin and has improved pregnancy outcomes to achieve successful live birth in >70% of pregnancies. Although hydroxychloroquine and pravastatin might further improve pregnancy outcomes, prospective clinical trials are required to confirm these findings.

U2 - 10.1038/nrdp.2017.103

DO - 10.1038/nrdp.2017.103

M3 - Review

C2 - 29321641

SN - 2056-676X

VL - 4

JO - Nature Reviews. Disease Primers

JF - Nature Reviews. Disease Primers

M1 - 17103

ER -

Antiphospholipid syndrome

Abstract

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