Publish in this journal
Journal Information
Vol. 213. Issue 2.
Pages 108-113 (March 2013)
Share
Share
Download PDF
More article options
ePub
Visits
...
Vol. 213. Issue 2.
Pages 108-113 (March 2013)
Special article
DOI: 10.1016/j.rceng.2012.04.001
Clinical advances of interest in the diagnosis and treatment of patients with antiphospholipid syndrome
Avances de interés clínico en el diagnóstico y tratamiento de los pacientes con síndrome antifosfolípido
Visits
...
J.L. Rodríguez Garcíaa, M.A. Khamashtab,??
Corresponding author
munther.khamashta@kcl.ac.uk

Corresponding author.
a Servicio de Medicina Interna, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
b Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, London, England, United Kingdom
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Tables (5)
Table 1. Characteristics of patients with seronegative APS vs. those with seropositive APS.
Table 2. Clinical manifestations of seronegative vs. seropositive APS patients.
Table 3. APS and long-term treatment with LMWH. Clinical and demographic characteristics and previous treatment with warfarin.
Table 4. Significant clinical data on patients with APS treated with long-term LMWH.
Table 5. Recommendations for the prevention and long-term treatment of thrombosis in patients with APA. Galveston Consensus (2010).a
Show moreShow less
Abstract

In this paper we review recent studies and consensus documents that we consider relevant to the diagnosis and treatment of patients with antiphospholipid syndrome (APS). The diagnosis of APS is based on the Sydney classification criteria (2006), in which positive laboratory tests (anticardiolipin antibodies, anti-β2-glycoprotein I antibodies or lupus anticoagulant) are mandatory. However, it is not uncommon to see patients with clinical features highly suggestive of the syndrome in whom these antibodies are persistently negative. Therefore, we summarize the principal clinical and serological findings in a subgroup of patients with seronegative APS in the first series published up to date. In addition, a recent study draws attention to the safety and efficacy of the long-term use of low-molecular-weight heparins in patients with APS not susceptible to warfarin treatment. There is also a subgroup of women with APS and recurrent fetal loss with no response to the standard antithrombotic therapy; in this group the materno-fetal prognosis could be improved by the addition of low-dose prednisolone during the first trimester of pregnancy. Finally, we list the principal recommendations regarding thromboprophylaxis in APS drawn from the expert consensus document elaborated at the meeting held in Galvestone (2010).

Keywords:
Antiphospholipid syndrome
Review
Treatment
Seronegative antiphospholipid syndrome
Resumen

En este artículo se repasan algunos de los estudios y documentos de consenso recientes que hemos creído relevantes en el ámbito del diagnóstico y tratamiento de los pacientes con síndrome antifosfolípido (SAF). El diagnóstico del SAF se basa en los criterios de clasificación de Sidney (2006), donde la positividad de las pruebas de laboratorio (anticuerpos anticardiolipina, anti-β2-glicoproteína 1 o anticoagulante lúpico) supone un requisito necesario. Sin embargo, no es infrecuente encontrar pacientes con clínica muy sugestiva del síndrome y ausencia de estos anticuerpos. En este sentido, resumimos los principales hallazgos clínicos y serológicos de un subgrupo de pacientes con SAF seronegativo en la primera serie publicada hasta la actualidad.

En relación con el tratamiento antitrombótico, un estudio reciente ha señalado la seguridad y eficacia del uso de heparinas de bajo peso molecular a largo plazo en pacientes con SAF no subsidiarios de tratamiento con dicumarínicos. Por otro lado, existe un subgrupo de pacientes con SAF y pérdidas fetales recurrentes, cuyo pronóstico materno-fetal puede verse mejorado con la administración de bajas dosis de esteroides durante el primer trimestre de gestación. Finalmente, recogemos las principales recomendaciones sobre tromboprofilaxis en el SAF extraídas del consenso de expertos de la reunión celebrada en Galvestone (2010).

Palabras clave:
Síndrome antifosfolípido
Revisión
Tratamiento
Síndrome antifosfolípido seronegativo

Article

These are the options to access the full texts of the publication Revista Clínica Española (English Edition)
Member
Si es usted socio de FESEMI siga los siguientes pasos:

Diríjase desde aquí a la web de la >>>FESEMI<<< e inicie sesión mediante el formulario que se encuentra en la barra superior, pulsando sobre el candado.

Una vez autentificado, en la misma web de FESEMI, en el menú superior, elija la opción deseada.

>>>FESEMI<<<

Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Revista Clínica Española (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Revista Clínica Española (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?