Le syndrome des antiphospholipides en néphrologie. Atteinte rénale et aspects pratiques de la prise en charge
Le syndrome des antiphospholipides est une thrombophilie caractérisée par l’association d’un événement clinique thrombotique (artériel et/ou veineux) ou obstétrical, associé à la présence durable d’anticorps antiphospholipides. L’atteinte pouvant toucher l’ensemble de l’arbre vasculaire, une atteint...
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| Published in | Néphrologie & thérapeutique Vol. 10; no. 1; pp. 1 - 9 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | French |
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Issy-les-Moulineaux
Elsevier SAS
01.02.2014
Elsevier Masson Elsevier Masson (jusqu'en 2022) / John Libbey Eurotext (à partir de 2023) |
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| Abstract | Le syndrome des antiphospholipides est une thrombophilie caractérisée par l’association d’un événement clinique thrombotique (artériel et/ou veineux) ou obstétrical, associé à la présence durable d’anticorps antiphospholipides. L’atteinte pouvant toucher l’ensemble de l’arbre vasculaire, une atteinte rénale est fréquemment associée avec la description maintenant bien codifiée de la néphropathie associée au syndrome des antiphospholipides. Nous proposons dans cette revue des recommandations actualisées sur la prise en charge du syndrome des antiphospholipides en néphrologie. La thérapeutique se base sur une anticoagulation plus ou moins une antiagrégation à long terme en fonction des événements cliniques sans oublier le recours à une néphroprotection classique (contrôle strict de la pression artérielle avec notamment des thérapeutiques bloquant le système rénine–angiotensine–aldostérone). Le syndrome catastrophique des antiphospholipides est une complication extrêmement grave pouvant mettre en jeu le pronostic vital du patient. Celui-ci justifie une attention toute particulière, ainsi qu’une prévention dans les situations à risque. Nous illustrons également les difficultés de prise en charge au long cours de ces patients, tant en dialyse qu’en transplantation rénale.
The antiphospholipid syndrome is a thrombophilia characterized by the combination of arterial and/or venous thrombotic events or obstetric clinical events, associated with persistent presence of antiphospholipid antibodies. In this syndrome, thromboses may affect all of the vascular tree, renal damage is frequently associated with a specific antiphospholipid syndrome nephropathy. We propose in this review to provide updated recommendations on the management of antiphospholipid syndrome in nephrology. Treatment is based on long-term anticoagulant therapy with or without antiplatelet agents according to clinical events. The use of a conventional nephroprotection must not be forgotten (strict control of blood pressure with drugs blocking the renin–angiotensin–aldosterone system). Catastrophic antiphospholipid syndrome is an extremely severe complication which can threaten the vital prognosis of the patient. This justifies particular surveillance, as well as prevention in high-risk situations. We also illustrate the difficulties of long-term management in these patients, both in dialysis or kidney transplantation. |
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| AbstractList | Le syndrome des antiphospholipides est une thrombophilie caractérisée par l’association d’un événement clinique thrombotique (artériel et/ou veineux) ou obstétrical, associé à la présence durable d’anticorps antiphospholipides. L’atteinte pouvant toucher l’ensemble de l’arbre vasculaire, une atteinte rénale est fréquemment associée avec la description maintenant bien codifiée de la néphropathie associée au syndrome des antiphospholipides. Nous proposons dans cette revue des recommandations actualisées sur la prise en charge du syndrome des antiphospholipides en néphrologie. La thérapeutique se base sur une anticoagulation plus ou moins une antiagrégation à long terme en fonction des événements cliniques sans oublier le recours à une néphroprotection classique (contrôle strict de la pression artérielle avec notamment des thérapeutiques bloquant le système rénine–angiotensine–aldostérone). Le syndrome catastrophique des antiphospholipides est une complication extrêmement grave pouvant mettre en jeu le pronostic vital du patient. Celui-ci justifie une attention toute particulière, ainsi qu’une prévention dans les situations à risque. Nous illustrons également les difficultés de prise en charge au long cours de ces patients, tant en dialyse qu’en transplantation rénale.
The antiphospholipid syndrome is a thrombophilia characterized by the combination of arterial and/or venous thrombotic events or obstetric clinical events, associated with persistent presence of antiphospholipid antibodies. In this syndrome, thromboses may affect all of the vascular tree, renal damage is frequently associated with a specific antiphospholipid syndrome nephropathy. We propose in this review to provide updated recommendations on the management of antiphospholipid syndrome in nephrology. Treatment is based on long-term anticoagulant therapy with or without antiplatelet agents according to clinical events. The use of a conventional nephroprotection must not be forgotten (strict control of blood pressure with drugs blocking the renin–angiotensin–aldosterone system). Catastrophic antiphospholipid syndrome is an extremely severe complication which can threaten the vital prognosis of the patient. This justifies particular surveillance, as well as prevention in high-risk situations. We also illustrate the difficulties of long-term management in these patients, both in dialysis or kidney transplantation. The antiphospholipid syndrome is a thrombophilia characterized by the combination of arterial and/or venous thrombotic events or obstetric clinical events, associated with persistent presence of antiphospholipid antibodies. In this syndrome, thromboses may affect all of the vascular tree, renal damage is frequently associated with a specific antiphospholipid syndrome nephropathy. We propose in this review to provide updated recommendations on the management of antiphospholipid syndrome in nephrology. Treatment is based on long-term anticoagulant therapy with or without antiplatelet agents according to clinical events. The use of a conventional nephroprotection must not be forgotten (strict control of blood pressure with drugs blocking the renin-angiotensin-aldosterone system). Catastrophic antiphospholipid syndrome is an extremely severe complication which can threaten the vital prognosis of the patient. This justifies particular surveillance, as well as prevention in high-risk situations. We also illustrate the difficulties of long-term management in these patients, both in dialysis or kidney transplantation. Le syndrome des antiphospholipides est une thrombophilie caractérisée par l’association d’un événement clinique thrombotique (artériel et/ou veineux) ou obstétrical, associé à la présence durable d’anticorps antiphospholipides. L’atteinte pouvant toucher l’ensemble de l’arbre vasculaire, une atteinte rénale est fréquemment associée avec la description maintenant bien codifiée de la néphropathie associée au syndrome des antiphospholipides. Nous proposons dans cette revue des recommandations actualisées sur la prise en charge du syndrome des antiphospholipides en néphrologie. La thérapeutique se base sur une anticoagulation plus ou moins une antiagrégation à long terme en fonction des événements cliniques sans oublier le recours à une néphroprotection classique (contrôle strict de la pression artérielle avec notamment des thérapeutiques bloquant le système rénine–angiotensine–aldostérone). Le syndrome catastrophique des antiphospholipides est une complication extrêmement grave pouvant mettre en jeu le pronostic vital du patient. Celui-ci justifie une attention toute particulière, ainsi qu’une prévention dans les situations à risque. Nous illustrons également les difficultés de prise en charge au long cours de ces patients, tant en dialyse qu’en transplantation rénale. |
| Author | Champigneulle, Jacqueline Dekeyser, Manon Wahl, Denis Zuily, Stéphane Frimat, Luc Eschwège, Valérie Perret-Guillaume, Christine |
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| Cites_doi | 10.1016/j.revmed.2012.01.005 10.1681/ASN.V13142 10.1191/0961203303lu394oa 10.1136/ard.2008.096669 10.1111/j.1600-6143.2010.03233.x 10.1111/j.1538-7836.2006.01753.x 10.1016/j.transproceed.2004.12.151 10.1016/0272-6386(95)90656-8 10.2215/CJN.00460110 10.1177/0961203307084724 10.1016/j.nephro.2011.12.005 10.1681/ASN.2007030257 10.1182/blood.V98.6.1760 10.1002/art.10187 10.1046/j.1523-1755.2002.00500.x 10.1002/art.22663 10.1093/ndt/gfq356 10.1681/ASN.V103507 10.1016/j.revmed.2008.05.013 10.1038/ki.1995.352 10.1046/j.1523-1755.1999.00258.x 10.1182/blood-2011-03-340232 10.1159/000235941 10.1093/ndt/7.12.1194 10.1097/00041552-200103000-00004 10.1136/ard.2010.142042 10.1097/00007890-199901150-00015 10.1161/CIRCULATIONAHA.111.028522 10.1016/j.autrev.2010.08.005 10.1016/j.revmed.2012.01.007 10.1038/ki.2011.477 10.1177/0961203310395803 |
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| Copyright | 2013 Association Société de néphrologie 2015 INIST-CNRS Distributed under a Creative Commons Attribution 4.0 International License |
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| Keywords | Traitement Treatment Dialyse Syndrome des antiphospholipides Transplantation Dialysis Néphropathie associée au syndrome des antiphospholipides Antiphospholipid syndrome Antiphospholipid syndrome nephropathy Immunopathologie Pathologie de l'appareil circulatoire Pathologie du rein Pathologie de l'appareil urinaire Pathologie des vaisseaux sanguins Néphropathie Lésion Prise en charge Hémopathie Urologie Greffe Maladie autoimmune Néphrologie Chirurgie Thrombocyte Conduite à tenir Rein Appareil urinaire |
| Language | French |
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| Snippet | Le syndrome des antiphospholipides est une thrombophilie caractérisée par l’association d’un événement clinique thrombotique (artériel et/ou veineux) ou... The antiphospholipid syndrome is a thrombophilia characterized by the combination of arterial and/or venous thrombotic events or obstetric clinical events,... |
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| SubjectTerms | Anticoagulants Antihypertensive Agents Antiphospholipid Syndrome Antiphospholipid syndrome nephropathy Arterial Occlusive Diseases Biopsy Cardiovascular Diseases Contraindications Dialyse Dialysis Disease Management Female Humans Kidney Diseases Kidney Transplantation Life Sciences Middle Aged Nephrologie. Maladies des voies urinaires Nervous System Diseases Néphropathie associée au syndrome des antiphospholipides Platelet Aggregation Inhibitors Renal Artery Renal Circulation Renal Dialysis Renal Veins Santé publique et épidémiologie Sciences biologiques et medicales Sciences medicales Syndrome des antiphospholipides Thrombocytopenia Thrombophilia Thrombosis Thrombotic Microangiopathies Traitement Transplantation Treatment |
| Title | Le syndrome des antiphospholipides en néphrologie. Atteinte rénale et aspects pratiques de la prise en charge |
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