Síndrome antifosfolípido
Summary
Definition
History and exam
Key diagnostic factors
- antecedentes o diagnóstico actual de trombosis vascular
- anamnesis de pérdida del embarazo
- antecedentes de morbilidad asociada al embarazo
Other diagnostic factors
- antecedentes de lupus eritematoso sistémico
- características de la trombocitopenia
- artralgia/artritis
- livedo reticularis
- antecedentes de otros trastornos reumatológicos o del tejido conectivo
- soplo cardíaco
- edema
- crisis convulsiva, cefalea, pérdida de memoria, signos de mielopatía transversa
- molestia en las extremidades, inflamación, decoloración de la piel y úlceras
Risk factors
- antecedentes de lupus eritematoso sistémico
- antecedentes de otros trastornos reumatológicos autoinmunitarios
- antecedentes de otras enfermedades autoinmunitarias
- antecedentes de trastornos hematológicos autoinmunitarios
Diagnostic tests
1st tests to order
- anticoagulante lúpico
- anticuerpos anticardiolipina
- anticuerpos anti-beta2-glucoproteína I
- anticuerpos antinucleares, ADN de doble cadena y antígenos nucleares extraíbles
- hemograma completo (HC)
- creatinina y urea
Tests to consider
- ultrasonido Doppler venoso
- venografía o resonancia magnética (IRM)
- resonancia magnética (IRM) de la trombosis
- angiografía de tórax por tomografía computarizada (TC)
- gammagrafía de ventilación-perfusión (V/P)
- resonancia magnética (IRM) craneal
- ecocardiografía
- prueba de trombofilia hereditaria
Treatment algorithm
no embarazadas con trombosis aguda
embarazadas
síndrome antifosfolípido (SAF) catastrófico (embarazadas y no embarazadas)
anticuerpos antifosfolípidos incidentales
Contributors
Authors
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
Disclosures
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
Disclosures
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
Disclosures
AD declares that he has no competing interests.
Acknowledgements
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.
Revisores
Kuntal Chakravarty, FRCP (London), FRCP (Glasgow), FRCP (Ireland), FACP (USA), FACR (USA)
Consultant Rheumatologist
BHRT University Hospital
Queen’s Hospital
Romford
UK
Declarações
KC declares that he has no competing interests.
Alan Lichtin, MD
Staff Hematologist
Cleveland Clinic Taussig Cancer Center
Cleveland
OH
Declarações
AL declares that he has no competing interests.
Créditos aos pareceristas
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Referências
Principais artigos
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.Texto completo Resumo
Barbhaiya M, Zuily S, Naden R, et al. 2023 ACR/EULAR antiphospholipid syndrome classification criteria. Ann Rheum Dis. 2023 Oct;82(10):1258-70.Texto completo Resumo
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.Texto completo Resumo
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.Texto completo Resumo
American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 132: antiphospholipid syndrome. Dec 2012 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Síndrome de Sneddon
- Trombofilia hereditaria
Mais Diagnósticos diferenciaisDiretrizes
- ACR/EULAR antiphospholipid syndrome classification criteria
- 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal disease
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