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Antiphospholipid Syndrome

  • Mala Arora
Chapter

Abstract

The antiphospholipid syndrome (APS) is an autoimmune condition characterized by recurrent arterial or venous thrombosis and recurrent pregnancy loss. The autoantibodies are targeted to negatively charged phospholipids, in the cell membrane. The prevalence of APS in general obstetric population is 2 %. However in women with autoimmune disorders like systemic lupus erythematosus (SLE), it is as high as 30 %. Among obstetric patients with early-onset severe pre-eclampsia, the prevalence can be as high as 30 %.

Keywords

Systemic Lupus Erythematosus Pregnancy Loss Lupus Anticoagulant Recurrent Pregnancy Loss Early Pregnancy Loss 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Harris EN, Charavi AE, Boey ML, Patel BM, Mackworth-Young CG, Loizou S, Hughes GRV. Anticardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. Lancet. 1983;2:1211–4.CrossRefPubMedGoogle Scholar
  2. 2.
    Hughes GRV, Harris EN, Gharavi AE. The anticardiolipin syndrome. J Rheumatol. 1985;13:486–9.Google Scholar
  3. 3.
    Shoenfeld Y, Meroni PL. The beta-2 glycoprotein I and antiphospholipid antibodies. Clin Exp Rheumatol. 1992;10:205–9.PubMedGoogle Scholar
  4. 4.
    Bevers EM, Galli M, Barbui T, Comfurius P, Zwaal RF. Lupus anticoagulants IgG’s (LA) are not directed to phospholipids only but to a complex of lipid-bound human prothrombin. Thromb Haemost. 1991;66:629–32.PubMedGoogle Scholar
  5. 5.
    Horstman LL, Jy W, Bidot CJ, Ahn YS, Kelley RE, Zivadinov R, Maghzi AH, Etemadifar M, Mousavi SA, Minagar A. Antiphospholipid antibodies: paradigm in transition. J Neuroinflammation. 2009;6:3.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Ieko M, Nakabayashi T, Tarumi T, Yoshida M, Naito S, Atsumi T, Koike T. Phosphatidylserine dependent anti prothrombin antibody as a new marker for the diagnosis of antiphospholipid syndrome. Rinsho Byori. 2006;54(3):256–62 (article in Japanese).PubMedGoogle Scholar
  7. 7.
    McNeil HP, Chesterman CN, Krilis SA. Anticardiolipin antibodies and lupus anticoagulants comprise separate antibody subgroups with different phospholipids binding characteristics. Br J Haematol. 1989;73:506–13.CrossRefPubMedGoogle Scholar
  8. 8.
    Kandiah DA, Krilis SA. Laboratory detection of antiphospholipid antibodies. Lupus. 1996;5:160–2.CrossRefPubMedGoogle Scholar
  9. 9.
    Pierangeli SS, Gharavi AE. Testing for antiphospholipid antibodies: problems and solutions. Clin Obstet Gynecol. 2001;44:48–57.CrossRefPubMedGoogle Scholar
  10. 10.
    Lowe GD. Virchow’s triad revisited: abnormal flow. Pathophysiol Haemost Thromb. 2004;33:455–7.CrossRefGoogle Scholar
  11. 11.
    Gharavi AE, Pierangeli SS, Levy RA, Harris EN. Mechanisms of pregnancy loss in antiphospholipid syndrome. Clin Obstet Gynecol. 2001;44(1):11–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Geis W, Branch DW. Obstetric implications of antiphospholipid antibodies: pregnancy loss and other complications. Clin Obstet Gynecol. 2001;44:2–10.CrossRefPubMedGoogle Scholar
  13. 13.
    Caruso A, De Carolis S, Di Simon N. Antiphospholipid antibodies in obstetrics: new complexities and sites of action. Hum Reprod Update. 1999;5(3):267–76.CrossRefPubMedGoogle Scholar
  14. 14.
    Salmon JE. Antiphospholipid antibodies revisited: a disorder initiated by inflammation [Theodore E Woodward Award]. Trans Am Clin Climatol Assoc. 2007;118:99–114.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Wilson WA. Classification criteria for antiphospholipid syndrome. Rheum Dis Clin North Am. 2001;27(3):499–505, v.CrossRefPubMedGoogle Scholar
  16. 16.
    Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RH, DE Groot PG, Koike T, Meroni PL, Reber G, Shoenfeld Y, Tincani A, Vlachoyiannopoulos PG, Krilis SA. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4(2):295–306.CrossRefPubMedGoogle Scholar
  17. 17.
    Salvagno GL, Lippi G, Franchini M, Targher G, Montagnana M, Franchi M, Guidi GC. The cost-benefit ratio of screening pregnant women for thrombophilia. Blood Transfus. 2007;5(4):189–203.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Levine JS, Branch DW, Rauch J. The antiphospholipid syndrome. N Engl J Med. 2002;346:752–63.CrossRefPubMedGoogle Scholar
  19. 19.
    Vaarala O, Palosuo T, Kleemola M, Aho K. Anticardiolipin response in acute infections. Clin Immunol Immunopathol. 1986;41:8–15.CrossRefPubMedGoogle Scholar
  20. 20.
    Goel N, Ortel TL, Bali D, Anderson JP, Gourley IS, Smith H, Morris CA, DeSimone M, Branch DW, Ford P, Berdeaux D, Roubey RAS, Kostyu DD, Kingsmore SF, Thiel T, Amos C, Seldin M. Familial antiphospholipid antibody syndrome: criteria for disease and evidence for autosomal dominant inheritance. Arthritis Rheum. 1999;42:318–27.CrossRefPubMedGoogle Scholar
  21. 21.
    Cervera R, Bucciarelli S, Plasín MA, Gómez-Puerta JA, Plaza J, Pons-Estel G, Shoenfeld Y, Ingelmo M, Espinos G, Catastrophic Antiphospholipid Syndrome (CAPS) Registry Project Group (European Forum On Antiphospholipid Antibodies). Catastrophic antiphospholipid syndrome (CAPS): descriptive analysis of a series of 280 patients from the “CAPS Registry”. J Autoimmun. 2009;32(3–4):240–5. Epub 2009 Mar 26.CrossRefPubMedGoogle Scholar
  22. 22.
    Tuthill JI, Khamashta MA. Management of antiphospholipid syndrome. J Autoimmun. 2009;33(2):92–8. Epub 2009 Jun 25.CrossRefPubMedGoogle Scholar
  23. 23.
    Erkan D, Lockshin MD. Antiphospholipid syndrome. Curr Opin Rheumatol. 2006;18(3):242–8.PubMedGoogle Scholar
  24. 24.
    CLASP: a randomised trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnant women. CLASP (Collaborative Low-dose Aspirin Study in Pregnancy) Collaborative Group. Lancet. 1994;343(8898):619–29.Google Scholar
  25. 25.
    Knight M, Duley L, Henderson-Smart DJ, King JF. WITHDRAWN: antiplatelet agents for preventing and treating pre-eclampsia. Cochrane Database Syst Rev. 2007;18;(2):CD000492.Google Scholar
  26. 26.
    Sasidharan CK, Kutty PM, Ajithkumar, Sajith N. Fetal intracranial hemorrhage due to antenatal low dose aspirin intake. Indian J Pediatr. 2001;68(11):1071–2.CrossRefPubMedGoogle Scholar
  27. 27.
    Ecker E, Gross P. Anticomplementary power of heparin. J Infect Dis. 1929;44:250.CrossRefGoogle Scholar
  28. 28.
    Bar J, Cohen-Sacher B, Hod M, et al. Low molecular weight heparin for thrombophilia in pregnant women. Int J Gynaecol Obstet. 2000;69:209–13.CrossRefPubMedGoogle Scholar
  29. 29.
    Brenner B, Hoffman R, Blumenfeld Z, et al. Gestational outcome in thrombophilic women with recurrent pregnancy loss treated by enoxaparin. Thromb Haemost. 2000;83:693–7.PubMedGoogle Scholar
  30. 30.
    Lim W, Crowther MA, Eikelboom JW. Management of antiphospholipid antibody syndrome: a systematic review. JAMA. 2006;295(9):1050–7.CrossRefPubMedGoogle Scholar
  31. 31.
    Nelson-Piercy C. Handbook of obstetric medicine, 4th ed, Informa health care. 2011, p 150.Google Scholar
  32. 32.
    Schünemann HJ, Cook D, Grimshaw J, Liberati A, Heffner J, Tapson V, Guyatt G. Antithrombotic and thrombolytic therapy: from evidence to application: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126:401S–512.CrossRefGoogle Scholar
  33. 33.
    Cowchock FS, Reece AE, Balaban D, Branch DW, Plouffe L. Repeated fetal losses associated with antiphospholipid antibodies: a collaborative randomized trial comparing prednisone with low-dose aspirin. Am J Obstet Gynecol. 1992;166:1318–23.CrossRefPubMedGoogle Scholar
  34. 34.
    Khamastha MA. Management of thrombosis and pregnancy loss in antiphospholipid syndrome. Lupus. 1998;7 Suppl 2:S162–5.CrossRefGoogle Scholar
  35. 35.
    Clark AL, Branch DW, Silver RM, et al. Pregnancy complicated by the antiphospholipid syndrome: outcomes with intravenous immunoglobulin therapy. Obstet Gynecol. 1999;93:437–41.PubMedGoogle Scholar
  36. 36.
    Spinnato JA, Clark AL, Pierangeli SS, et al. Intravenous immunoglobulin therapy for antiphospholipid syndrome in pregnancy. Am J Obstet Gynecol. 1995;172:690–4.CrossRefPubMedGoogle Scholar
  37. 37.
    Branch DW, Peaceman AM, Druzin M, et al. A multicenter, placebo-controlled pilot study of intravenous immune globulin treatment of antiphospholipid syndrome during pregnancy. The pregnancy loss study group. Am J Obstet Gynecol. 2000;182:122–7.CrossRefPubMedGoogle Scholar
  38. 38.
    Jajoria P, Murthy V, Papalardo E, Romay-Penabad Z, Gleason C, Pierangeli SS. Statins for the treatment of antiphospholipid syndrome? Ann N Y Acad Sci. 2009;1173:736–45.CrossRefPubMedGoogle Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  1. 1.Noble IVF Centre, Sector 14, Senior Consultant, Fortis La Femme GK2FaridabadIndia

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