小结
定义
病史和体格检查
关键诊断因素
- 血管血栓形成病史或当前诊断
- 妊娠丢失病史
- 妊娠相关疾病病史
其他诊断因素
- 系统性红斑狼疮病史
- 血小板减少症的特征
- 关节痛/关节炎
- 网状青斑
- 其他风湿疾病或结缔组织病病史
- 心脏杂音
- 水肿
- 癫痫发作、头痛、记忆丧失和横贯性脊髓病征象
- 肢体不适、肿胀、皮肤褪色和溃疡
危险因素
- 系统性红斑狼疮病史
- 其他自身免疫性风湿疾病病史
- 其他自身免疫性疾病病史
- 自身免疫性血液系统疾病病史
诊断性检查
首要检查
- 狼疮抗凝物
- 抗心磷脂抗体
- 抗 β2 糖蛋白 I 抗体
- 抗核抗体、抗双链 DNA 抗体和抗可提取性核抗原抗体
- 全血细胞计数 (FBC)
- 肌酐和尿素
需考虑的检查
- 静脉多普勒超声
- 静脉造影或 MRI
- 血栓 MRI
- 胸部 CT 血管造影
- 通气与血流灌注比值 (V/Q) 扫描
- 头颅 MRI
- 超声心动图
- 遗传性易栓症检查
治疗流程
有急性血栓形成的非妊娠者
妊娠
灾难性 APS(妊娠或非妊娠)
偶然发现抗磷脂抗体
撰稿人
作者
Damon Houghton, MD, MS
Assistant 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
利益声明
DH declares that he has no competing interests.
Ana Casanegra, MD, MS
Associate Professor of Medicine
Mayo Clinic
Gonda Vascular Center
Department of Cardiovascular Diseases, Division of Vascular Medicine
Rochester
MN
利益声明
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
利益声明
AD declares that he has no competing interests.
鸣谢
Dr Damon Houghton, Dr Ana 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.
同行评议者
Kuntal Chakravarty, FRCP (London), FRCP (Glasgow), FRCP (Ireland), FACP (USA), FACR (USA)
Consultant Rheumatologist
BHRT University Hospital
Queen’s Hospital
Romford
UK
利益声明
KC declares that he has no competing interests.
Alan Lichtin, MD
Staff Hematologist
Cleveland Clinic Taussig Cancer Center
Cleveland
OH
利益声明
AL declares that he has no competing interests.
鉴别诊断
- Sneddon 综合征
- 遗传性易栓症
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