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Antiphospholipid syndrome

Última revisão: 20 Aug 2025
Última atualização: 16 Aug 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • history or current diagnosis of vascular thrombosis
  • history of pregnancy loss
  • history of pregnancy-associated morbidity
Detalhes completos

Outros fatores diagnósticos

  • history of systemic lupus erythematosus
  • features of thrombocytopenia
  • arthralgia/arthritis
  • livedo reticularis
  • history of other rheumatologic disorders or connective tissue disorders
  • cardiac murmur
  • edema
  • seizure, headache, memory loss, signs of transverse myelopathy
  • limb discomfort, swelling, skin discoloration, and ulcers
Detalhes completos

Fatores de risco

  • history of systemic lupus erythematosus
  • history of other autoimmune rheumatologic disorders
  • history of other autoimmune diseases
  • history of autoimmune hematologic disorders
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • lupus anticoagulant
  • anticardiolipin antibodies
  • anti-beta2-glycoprotein I antibodies
  • antinuclear antibody, double-stranded DNA, and extractable nuclear antigen antibodies
  • CBC
  • creatinine and BUN
Detalhes completos

Investigações a serem consideradas

  • venous Doppler ultrasound
  • venography or MRI
  • MRI of thrombosis
  • CT angiogram of the chest
  • ventilation-perfusion (V/Q) scan
  • cranial MRI
  • echocardiography
  • inherited thrombophilia test
Detalhes completos

Algoritmo de tratamento

AGUDA

nonpregnant with acute thrombosis

pregnant

catastrophic APS (pregnant or nonpregnant)

CONTÍNUA

incidental antiphospholipid antibodies

Colaboradores

Autores

Damon Houghton, MD, MS

Associate Professor of Medicine

Mayo Clinic

Gonda Vascular Center

Department of Internal Medicine, Division of Hematology & Department of Cardiovascular Diseases, Division of Vascular Medicine

Rochester

MN

Раскрытие информации

DH has received clinical research support from Veralox and Bayer.

Ana I. Casanegra, MD, MS

Associate Professor of Medicine

Mayo Clinic

Gonda Vascular Center

Department of Cardiovascular Diseases, Division of Vascular Medicine

Rochester

MN

Раскрытие информации

AC declares that she has no competing interests.

Alí Duarte-García, MD, MSc

Assistant Professor of Medicine

Mayo Clinic

Department of Internal Medicine, Division of Rheumatology

Rochester

MN

Раскрытие информации

AD declares that he has no competing interests.

Выражение благодарностей

Dr Damon Houghton, Dr Ana I. Casanegra and Dr Alí Duarte-García would like to gratefully acknowledge Dr Karen A. Breen and Dr Beverley J. Hunt, the previous contributors to this topic. KAB has performed consultancy work for Bayer/Pfizer. BJH is Medical Director of Thrombosis UK and chair of the steering committee for World Thrombosis Day. BJH is an author of a reference cited in this topic.

Рецензенты

Kuntal Chakravarty, FRCP (London), FRCP (Glasgow), FRCP (Ireland), FACP (USA), FACR (USA)

Consultant Rheumatologist

BHRT University Hospital

Queen’s Hospital

Romford

UK

Раскрытие информации

KC declares that he has no competing interests.

Alan Lichtin, MD

Staff Hematologist

Cleveland Clinic Taussig Cancer Center

Cleveland

OH

Раскрытие информации

AL declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

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Основные статьи

Miyakis S, Lockshin MD, Atsumi T, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006 Feb;4(2):295-306.Полный текст  Аннотация

Barbhaiya M, Zuily S, Naden R, et al. 2023 ACR/EULAR antiphospholipid syndrome classification criteria. Ann Rheum Dis. 2023 Oct;82(10):1258-70.Полный текст  Аннотация

Tektonidou MG, Andreoli L, Limper M, et al. EULAR recommendations for the management of antiphospholipid syndrome in adults. Ann Rheum Dis. 2019 Oct;78(10):1296-304.Полный текст  Аннотация

Sammaritano LR, Bermas BL, Chakravarty EE, et al. 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases. Arthritis Rheumatol. 2020 Apr;72(4):529-56.Полный текст  Аннотация

American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 132: antiphospholipid syndrome. Dec 2012 [internet publication].Полный текст

Статьи, указанные как источники

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