Extra-criteria clinical manifestations of antiphospholipid antibody should not be ignored

• Published in: Chinese medical journal Vol. 135; no. 18; pp. 2251 - 2252
• Main Authors: Huang, Can, Hu, Chaojun, Zhao, Jiuliang, Wang, Qian, Tian, Xinping, Li, Mengtao, Zeng, Xiaofeng
• Format: Journal Article
• Language: English
• Published: China Lippincott Williams & Wilkins 20.09.2022; Lippincott Williams & Wilkins Ovid Technologies; Wolters Kluwer
• Subjects: Antibodies; Antibodies, Antiphospholipid; Anticoagulants; Antiphospholipid Syndrome - diagnosis; Antiphospholipid Syndrome - drug therapy; Cardiovascular disease; Correspondence; Glycoproteins; Heart; Humans; Lupus; Migraine; Obstetrics; Thrombocytopenia; Thrombosis; Beijing China; China
• DOI: 10.1097/CM9.0000000000002128
• ISSN: 0366-6999; 2542-5641

The clinical symptoms of APS include many non-thrombotic manifestations, also called extra-criteria manifestations, including thrombocytopenia, aPL nephropathy, livedo reticularis, valve heart disease, and neurological manifestations. While thrombosis occurred in 44 (24.4%) patients and pregnant morbidity in 17 (9.4%), 119 (66.1%) patients were just persistent aPL positive only, 77 (42.8%) were totally asymptomatic, and 42 (23.3%) presented extra-criteria manifestations independently. Since there were also 30 APS patients with extra-criteria manifestations, the total frequencies of aPL associated extra-criteria manifestations were 40% (72/180). The most common extra-criteria manifestations were thrombocytopenia (31.7%), neurological manifestations (10.0%), and valve heart disease (8.3%), they were more common in secondary APS compared with primary APS and non-APS-aPL+ patients [Table 1]. Items All (n = 180) PAPS (n = 27) SAPS (n = 34) Non-APS aPL+ (n = 119) P values Female, n (%) 131 (72.8) 18 (66.7) 26 (76.5) 87 (73.1) 0.687 Age (years), mean (SD) 40.3 (17.6) 37.8 (11.0) 37.7 (15.4) 41.6 (19.4) 0.384 Anti-β2GPI antibody, n (%) 149 (82.8) 25 (92.6) 29 (85.3) 95 (79.8) 0.259 aCL, n (%) 107 (59.4) 18 (66.7) 24 (70.6) 65 (54.6) 0.175 LA, n (%) 65 (36.1) 13 (48.1) 17 (50) 35 (29.4) 0.032 Triple aPL+, n (%) 46 (25.6) 11 (40.7) 14 (41.2) 21 (17.6) 0.003 pt w/extra-criteria, n (%) 72 (40.0) 9 (33.3) 21 (61.8) 42 (35.3) 0.016 Thrombocytopenia, n (%) 57 (31.7) 6 (22.2) 18 (52.9) 33 (27.7) 0.011 Livedo reticularis, n (%) 3 (1.7) 0 (0) 2 (6.5) 1 (0.8) 0.151 APL nephrology, n (%) 6 (3.3) 2 (7.4) 4 (12.9) 0 (0) 0.001 Valve heart disease, n (%) 15 (8.3) 2 (7.4) 7 (20.6) 6 (5.0) 0.015 Neurological, n (%) 18 (10) 3 (11.1) 8 (23.5) 7 (5.9) 0.010 Fisher's exact test. aCL: [...]40% aPL-positive patients presented with extra-criteria manifestations regardless of thrombotic or obstetric events, more common in SLE patients.