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
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
Fatores de risco
- history of systemic lupus erythematosus
- history of other autoimmune rheumatologic disorders
- history of other autoimmune diseases
- history of autoimmune hematologic disorders
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
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
Algoritmo de tratamento
nonpregnant with acute thrombosis
pregnant
catastrophic APS (pregnant or nonpregnant)
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
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
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Sneddon syndrome
- Inherited thrombophilia
Больше ОтличияРекомендации
- ACR/EULAR antiphospholipid syndrome classification criteria
- Addendum to British Society for Haematology Guidelines on Investigation and Management of Antiphospholipid syndrome, 2012 (Br. J. Haematol. 2012; 157: 47–58): use of direct acting oral anticoagulants
Больше РекомендацииЛифлеты для пациента
Deep vein thrombosis
Miscarriage
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