Hospital based prospective longitudinal clinical and immunologic study of 179 patients of primary anti-phospholipid syndrome

• Published in: International journal of rheumatic diseases 2013-10, Vol.16 (5), p.547-555
• Main Authors: Singh, Nand K., Behera, Dibya R., Agrawal, Ankit, Singh, Mahendra Narayan, Kumar, Vikash, Godhra, Manoj, Gupta, Anurag, Yadav, Devesh P., Singh, Usha, Pandey, Lakshmi Kant, Matah, Manjari
• Format: Article
• Language: English
• Subjects: Abortion, Spontaneous - epidemiology; Abortion, Spontaneous - immunology; Adolescent; Adult; Age; anti-phospholipid syndrome; Antiphospholipid Syndrome - blood; Antiphospholipid Syndrome - diagnosis; Antiphospholipid Syndrome - epidemiology; Antiphospholipid Syndrome - immunology; Arterial Occlusive Diseases - epidemiology; Arterial Occlusive Diseases - immunology; Autoantibodies - blood; Autoimmunity; Biomarkers - blood; Child; Female; Hospitals, University; Humans; India - epidemiology; Longitudinal Studies; Male; Middle Aged; Predictive Value of Tests; Pregnancy; pregnancy loss; Prevalence; Prognosis; Prospective Studies; Rheumatic Diseases - blood; Rheumatic Diseases - diagnosis; Rheumatic Diseases - epidemiology; Rheumatic Diseases - immunology; Risk Factors; Time Factors; venous and arterial thrombosis; Venous Thrombosis - epidemiology; Venous Thrombosis - immunology; Young Adult
• ISSN: 1756-1841; 1756-185X
• DOI: 10.1111/1756-185X.12150

Aim To study the clinical and immunological features of primary antiphospholipid syndrome (APS), and to analyze the differences between primary APS and APS associated with autoimmune rheumatic disease (ARD/APS). Methods This prospective, longitudinal study, carried out from December 2004 to July 2011 included 179 patients with primary APS and 52 patients of ARD/APS diagnosed as per modified 2006 Sapporo's Criteria. Results Out of 179 patients of primary APS, 12 were male and 167 were female. The mean age at the time of study entry was 27 ± 4.33 years. Venous thrombosis was noted in 33 (18.43%) patients. Seventeen patients had deep vein thrombosis and 11 (7.19%) had cortical vein and/or cortical sinus thrombosis. Arterial thrombosis was noted in 19 (10.61%) patients, out of which nine had intracranial arterial thrombosis. Thirty‐two (17.85%) had recurrent early fetal losses ( 10 weeks). Immunoglobulin G (IgG) and IgM aCLA were present in 141 (78.77%) and 32 (17.87%) patients respectively, whereas lupus anticoagulant was present in 99 (55.3%) patients. In patients with bad obstetric outcome, lupus anticoagulant positivity was significantly more prevalent (P