Antiphospholipid syndrome: five year follow up
Article Abstract:
Most of the rheumatic diseases have an autoimmune component in which antibodies are inappropriately made against the body's own molecules. In some types of disease, antibodies are made against phospholipids (fats found in the membranes of cells and important in cell reactions) and other fats. These antiphospholipid antibodies are common in patients with systemic lupus erythematosus (SLE) or a lupus-like disease (a variant of SLE) and are associated with complications related to thrombosis (clot formation). These complications include repeated miscarriage, low levels of platelets (thrombocytopenia) or red blood cells, skin nodules or necrosis (death), and neurological problems. In primary antiphospholipid syndrome, the antibodies occur with vascular occlusions (blood vessels blockages) and thrombocytopenia without evidence of SLE. The association between changes in antibody levels and thrombotic events in 19 patients were evaluated over a five-year period. Patients were divided into two groups, the first group of 10 having no further thrombotic complications, while the second group of 9 suffered recurrent thrombotic events. In the first group, five patients had strokes and were treated with aspirin and/or an anticoagulant. Five patients had deep vein thromboses and were treated similarly, and four also received prednisolone, a steroid. In the second group, seven patients had deep vein thromboses, and brain vessels were involved in two cases. Additional thromboses occurred in those with prior deep vein thromboses in spite of anticoagulant therapy. These thromboses often occurred at times of hypercoagulability (enhanced blood clotting), such as after delivery or while using oral contraceptives. Some patients were transiently resistant to anticoagulants. Levels of antibodies against cardiolipin, a phospholipid, were similar in both groups, changed seldom over five years, and were apparently unrelated to thrombotic events. While steroids or azathioprine were useful in controlling SLE activity, these drugs did not seem to affect thrombotic events. Only one of three patients with primary antiphospholipid syndrome converted to lupus-like disease. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of the Rheumatic Diseases
Subject: Health
ISSN: 0003-4967
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Infective endocarditis, rheumatoid factor, and anticardiolipin antibodies
Article Abstract:
A recent study in the Annals of the Rheumatic Diseases reported two cases of systemic lupus erythematosus, an inflammatory disease of connective tissue, which were associated with infective endocarditis (inflammation of the heart due to infection) and increased levels of anticardiolipin antibodies. These are specialized proteins that specifically bind and inactivate the phosphate-containing lipid compound cardiolipin. Because many infections are associated with high levels of anticardiolipin antibodies, the possibility that the infective endocarditis may have caused the increase in anticardiolipin antibodies was investigated. Infective endocarditis has also been associated with the presence of rheumatoid factor, a globular protein detected in most patients with rheumatoid arthritis, as well as in many with false-positive Venereal Disease Research Laboratory (VDRL) tests, which check for sexually-transmitted disease. The presence and levels of anticardiolipin antibodies and rheumatoid factor, and response to the VDRL test were assessed in blood samples from 22 patients with infective endocarditis. Rheumatoid factor was present in 10 patients, whereas anticardiolipin antibodies were detected in only four patients. The VDRL test was positive in two patients who did not have anticardiolipin antibodies. The findings show that infective endocarditis was not associated an increase in anticardiolipin antibodies, and antibody levels were unrelated to rheumatoid factor levels or a positive VDRL test in patients with infective endocarditis. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of the Rheumatic Diseases
Subject: Health
ISSN: 0003-4967
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
The progressive systemic sclerosis/systemic lupus overlap: an unusual clinical progression
Article Abstract:
The connective tissue diseases, which are autoimmune disorders (meaning that the immune system is abnormally responding against the body's own tissues), are usually easily identifiable as separate disorders, such as rheumatoid arthritis, systemic lupus erythematosus (SLE), and progressive systemic sclerosis (PSS, scleroderma). There are disorders which feature specific overlaps of the characteristic clinical (medical) symptoms, one of which is called mixed connective tissue disease. A disorder in which lupus merges into scleroderma, without any features of mixed connective tissue disease, has been previously described but is rare. Three cases of this uncommon overlap of autoimmune diseases are described. The first patient, a 48-year-old woman, had lupus without systemic disease, but developed PSS eight years later, with skin involvement being predominant. The second patient, a male, had SLE at age nine and developed significant features of lupus eight years later, with symptoms of PSS then evolving many years later. The third patient, a 42-year-old woman, initially had PSS, and then developed symptoms of SLE six years later. Myositis, inflammation of muscles, occurred in the first and third patients. The symptoms, laboratory findings, and responses to drug treatment are described for each patient. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of the Rheumatic Diseases
Subject: Health
ISSN: 0003-4967
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Recurrent cerebral infarction and the antiphospholipid syndrome: effect of intravenous gammaglobulin in a patient with systemic lupus erythematosus
- Abstracts: Atrial fibrillation - risk marker for stroke. Randomized trials of warfarin for atrial fibrillation. Preliminary report of the stroke prevention in atrial fibrillation study
- Abstracts: Nancy Cruzan and the right to die. Bioethicists' statement on the U.S. Supreme Court's Cruzan decision. The bell tolls for a constitutional right to physician-assisted suicide
- Abstracts: Doppler assessment of the renal blood flow velocity waveform during indomethacin therapy for preterm labor and polyhydramnios
- Abstracts: Sexually transmitted diseases in victims of rape. Underdiagnosis of genital herpes by current clinical and viral-isolation procedures