Document Detail


Morbidity, mortality, and organ damage in patients with antiphospholipid syndrome.
MedLine Citation:
PMID:  22247356     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe morbidity, organ damage, mortality, and cause of death in patients with antiphospholipid syndrome (APS).
METHODS: Descriptive analysis of 135 patients. Patients were clustered according to initial event: arterial thrombosis including stroke (AT; n = 46), venous thrombosis including pulmonary emboli (VT; n = 53), or pregnancy morbidity (PM; n = 36). Disease progression according to initial event and prevalence of organ damage was observed.
RESULTS: APS occurs among young individuals (mean age 33.3 ± 11.9 yrs). One-third of the patients have APS secondary to systemic lupus erythematosus (SLE) or SLE-like disease. A broad spectrum of clinical manifestations mark the disease onset even before diagnosis. The pattern of initial presentation is preserved with regard to second event; VT is followed by VT (84%), AT is followed by AT (95%), and PM is followed by PM (88.9%). The highest morbidity is attributed to neurologic damage. PM is more likely to be followed by a second event, yet is associated with less organ damage than AT and VT. After a mean followup of 7.55 years, 29% of patients experienced organ damage and 5 died, with Systemic Lupus International Collaborating Clinics score associated with increased mortality (HR 1.31, 95% CI 1.07-1.60, p = 0.01, per 1-unit increase); hematological malignancies occurred in 2 patients after a cumulative followup of 1020 person-years. Coexistent SLE adds significant damage in patients with APS.
CONCLUSION: APS is a disease of young individuals, who experience increased morbidity. Neurologic damage is the most common cause of morbidity. AT at presentation as well as coexistent SLE are associated with poor outcome.
Authors:
Eleftheria P Grika; Panayiotis D Ziakas; Elias Zintzaras; Haralampos M Moutsopoulos; Panayiotis G Vlachoyiannopoulos
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Publication Detail:
Type:  Journal Article     Date:  2012-01-15
Journal Detail:
Title:  The Journal of rheumatology     Volume:  39     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-02     Completed Date:  2012-07-26     Revised Date:  2013-02-11    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  516-23     Citation Subset:  IM    
Affiliation:
Department of Pathophysiology, School of Medicine, National University of Athens, Athens, Greece.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antiphospholipid Syndrome / diagnosis,  epidemiology*,  mortality*
Comorbidity
Disease Progression*
Female
Follow-Up Studies
Humans
Lupus Erythematosus, Systemic / epidemiology*
Male
Pregnancy
Pregnancy Complications, Cardiovascular / epidemiology
Prevalence
Prognosis
Pulmonary Embolism / epidemiology
Survival Rate
Thrombosis / epidemiology*
Venous Thrombosis / epidemiology
Comments/Corrections
Comment In:
J Rheumatol. 2013 Jan;40(1):90
J Rheumatol. 2013 Jan;40(1):89   [PMID:  23280164 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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