Full Papers
The meaning of non-criteria clinical manifestations in a real-life primary antiphospholipid syndrome cohort
G. Hernández-Molina1, C. Maldonado-García2, M. Gamboa-Espíndola3, A.R. Cabral4
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
- Department of Medicine, Division of Rheumatology, The Ottawa Hospital, University of Ottawa, Canada. arcabral1952@gmail.com
CER17057
2024 Vol.42, N°5
PI 1029, PF 1034
Full Papers
PMID: 38179724 [PubMed]
Received: 13/08/2023
Accepted : 06/11/2023
In Press: 03/01/2024
Published: 14/05/2024
Abstract
OBJECTIVES:
We aimed to evaluate the prevalence of non-criteria clinical features in patients with primary antiphospholipid syndrome (APS), and to assess their relationship to thrombosis and damage.
METHODS:
We retrospectively included 177 primary APS patients, and/or patients who only achieved the serological Sydney criteria but had thrombocytopenia and/or haemolytic anaemia. We registered demographics, serology, treatment, thrombotic/obstetric manifestations and non-criteria clinical manifestations (cutaneous, haematologic, renal, heart valve disease, and neurological). We scored the DIAPS and a modified SLICC index. We used logistic regression and reported OR with 95% CI.
RESULTS:
78% were women with a median follow-up of 6.7 years. Thrombosis was found in 74% of patients, 29.3% had obstetric features, and 64% had non-criteria clinical manifestations. The frequency of the non-criteria clinical manifestation was: haematologic 40.1%, cutaneous 20.9%, neurologic 18%, cardiac 5% and renal 4.5%. Non-criteria features were associated with LA (OR 2.3, 95% 1.03–5.1) and prednisone use (OR 8.2, 95% CI 1.7–39.3). A DIAPS score ≥1 was associated with thrombosis (OR 53.1, 95% CI 17.8–15.2), prednisone use (OR 0.27, CI 95% 0.09-0.83) and neurological involvement (OR 6.4, 95% CI 1.05–39.8); whereas a modified SLICC ≥ 1 with thrombosis (OR 10.2; IC 95% 4.43-26.1), neurological involvement (OR 6.4, 95%CI 1.05–39.8), obstetric features (OR 0.32 CI 95% 0.12–0,81) and cutaneous features (OR 5.3, CI 95% 1.4–19), especially livedo reticularis (OR 5.45; IC 95% 1.49–19.8).
CONCLUSIONS:
Non-criteria clinical manifestations are common and associated with LA. Among them, neurologic involvement and the presence of livedo were associated with damage accrual.
