Lege Artis Medicinae

[Antiphospholipid syndrome]

GERGELY Péter1

FEBRUARY 24, 1993

Lege Artis Medicinae - 1993;3(02)

[Antiphospholipid syndrome is a recently recognized clinical entity characterized by the presence of deep vein and cerebral thrombosis, thrombocytopenia and recurrent fetal loss. The syndrome is caused by autoantibodies directed against phospholipid antigens. The clinical syndrome is most frequently associated with systemic lupus erythematosus.]

AFFILIATIONS

  1. Semmelweis Orvostudományi Egyetem, II. Belklinika Budapest

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Intraoperative ultrasonography during laparoscopic cholecystectiomia ]

ANTAL András, SCHMIDT Pál, TAKÁCS Judit, HADIJEV Janaki

[Our preliminary experience with intraoperative ultrasonography during laparoscopic cholecystectomy is presented. The importance of intraoperative diagnostic procedures in biliary surgery such as cholangiography and operativ ultrasonography are discussed.]

Lege Artis Medicinae

[Xamoterol in severe heart failure]

MATOS Lajos

[The two groups did not differ from each other in terms of improvement in clinical symptoms. Using a visual analogue scale and the Likart questionnaire, breathlessness appeared to be relieved with the active agent, but the duration of exertion or exercise capacity was found to be the same. Exercise-induced tachycardia and blood pressure elevation were attenuated with xamoterol (p < 0.01). The drug showed no arrhythmogenic effect. At 100 days after randomisation, 32 patients in the xamoterol group (9.1%) had died, compared with 6 (3.7%; p=0.02) of those treated with placebo.]

Lege Artis Medicinae

[Alcohol induced organ and tissue injury]

BÉLY Miklós

[The patho-histological characteristics of alcohol induced acute and chronic organ and tissue injuries were reviewed. Neuropathy and brain lesions, gastrointestinal tract in alcoholism, alcoholic liver disease, pancreatitis, cardiomyopathy, aseptic bone necrosis, rhabdomyolysis were discussed based on the literature. ]

Lege Artis Medicinae

[Oral precancerous lesions and conditions]

DOMBI Csaba, CZEGLÉDY Ágota, BÁNÓCZY Jolán

[Each year tumours, including oral cancers, result in more and more deaths in Hungary. The oral cavity has a special position, because the precancerous lesions and conditions which occur in it can be detected by simple procedures. The authors use the latest definitions and disease classifications approved by WHO, to systematize the essential knowledge for the early diagnosis of the most frequent precance roses in Hungary, taking into consideration aspects of clinical morphology, epidemiology, localizational frequency, the risk/level of the tumour and the main principles of treatment. In addition to a detailed description of leukoplakia, erythroplakia, smoker's palate, actinic cheilitis, lichen and sideropenic anaemia, cheilitis glandularis, cornu cutaneum, naevus pigmentosus, discoid lupus erythematosus, submucosus fibrosis, xeroderma pigmentosum and tertiery syphilis are also mentioned. The purpose of the review is to call attention to the fact, that, due to the significant increase in mortality caused by oral tumours, the early diagnostic activity of dentists should be supported by the awareness of general practitioners and a national stomatooncological screening network should be established. ]

Lege Artis Medicinae

[Common stand]

[Resolution of the Board of the Scientific Society for Public Health on tobacco advertising.]

All articles in the issue

Related contents

Clinical Neuroscience

Posterior reversible encephalopathy syndrome as an initial manifestation of systemic lupus erythematosus

AYAS Özözen Zeynep, ÖCAL Öncel Ruhsen, GÜNDOGDU Aksoy Asli

Posterior reversible encephalopathy syndrome (PRES) is a disorder which is diagnosed with its characteristic clinical and radiological findings, typically resolves with treatment. The prevalence of PRES in systemic lupus erythematosus (SLE) patients is not exactly known. A systemic disorder frequently appears as a presenting symptom in SLE. However, in rare cases, the disease starts with a neurological manifestation. Here we report a 35-year-old woman presenting with a headache and blurred vision. She had neurologic symptoms and cerebral lesions on magnetic resonance imaging (MRI) suggesting PRES. The patient was diagnosed with SLE during the etiological investigation of PRES. In this article, we aimed to emphasize that PRES as an initial presentation of SLE.

Clinical Neuroscience

[Repeated stroke, psychotic episode - primary antiphospholipid syndrome?]

CSIBRI Éva, FARKAS Márta

[The antiphospholipid syndrome described some 10 years ago is characterized by a predisposition to arterial and venous thrombosis and the presence of antiphospholipid antibodies. It is often associated with systemic lupus erythematosus, but its primary forms are also well known. Its clinical features are well known in neurology as well as in psychiatry. In this paper we present a case report with therapeutic implications. We discuss the importance of reccurent stroke at a young age in association with the possibility of a rare manifestation of antiphospholipid syndrome: organic brain disease, appearing in the form of schizoaffective psychopathological symptoms.]

Hungarian Immunology

[SS-A(Ro) and SS-B(La) autoantibodies in systemic lupus erythematosus]

SALLAI Krisztina, NAGY Eszter, GERGELY Péter

[OBJECTIVE - To assess the relation between clinical features and the presence of SS-A(Ro) and SS-B(La) autoantibodies in systemic lupus erythematosus. PATIENTS - The data of 200 patients with definite systemic lupus erythematosus were analysed. SSA( Ro) and SS-B(La) antibodies were assessed by enzyme immunoassay. RESULTS - 40.5% of systemic lupus erythematosus' patients were SS-A(Ro) and/or SS-B(La) antibody positive (’positive group’); the majority of such patients displayed both antibodies, 16.5% had SSA( Ro) antibodies alone, while only 2% has SS-B(La) antibodies alone. There were no differences in the occurrence of arthritis, secondary antiphospholipid syndrome and hematologic manifestations between the positive and negative groups; serositis was more common in the positive group. Skin manifestations, in particular subacute cutaneous lupus erythematosus and urticaria vasculitis were more frequent in the positive group, while kidney and central nervous system involvation, in particular severe forms were less frequent. Secondary Sjögren's syndrome occurred exclusively in antibody positive patients. Sm, RNP and Scl-70 antibodies were more frequently found in the positive group. CONCLUSIONS - The presence of SS-A(Ro) and/or SS-B(La) antibodies in systemic lupus erythematosus has some prognostic significance; in antibody-positive patients there is an increased risk for skin lesions (in particular subacute cutaneous lupus erythematosus and urticaria vasculitis) and secondary Sjögren’s syndrome and a decreased risk for severe nephritis or central nervous system involvement.]

Hungarian Immunology

[MCP-1 (monocyte chemoattractant protein-1) G/A and T-bet (T-helper promoter factor) C/G polymorphisms in primary Sjögren’s syndrome and systemic lupus erythematosus]

KOVÁCS Attila, KONCZ Ágnes, ENDREFFY Emőke, ARANKA László, PETRI Ildikó, ELLER József, SZALAI Csaba

[INTRODUCTION - Monocyte chemoattractant protein- 1 (MCP-1) is a β-chemokine involved in the attraction and accumulation of mononuclear granulocytes towards the site of inflammation. One of the transcriptional factors of T-cells is called T-bet. PATIENTS AND METHODS - The authors investigated the MCP-1-2518 G/A and T-bet 310 C/G (His33Gln) polymorphisms evaluating the distribution of the specific genotypes in 45 patients with primary Sjögren's syndrome (pSS), 51 patients with systemic lupus erythematosus (SLE), and in 320 healthy blood donors as the control group. MCP-1-2518 G/A and T-bet 310 C/G polymorphisms were detected with molecular genetic methods from the purified genomic DNA. RESULTS - The frequency of the MCP-1-2518 AG heterozygous genotype decreased tendentiously only in SLE patients, while the frequency of the MCP-1 AA homozygous genotype increased comparing to the control group (13.7% vs. 5.9%; Pearson’s χ2 test=6.125, ns.). Analyzing the genotype frequency for the MCP-1 wild (GG) and AA homozygous genotypes in pSS group, the MCP-1 AA homozygous genotype proved to be more frequent comparing to the control group (82.8%:17.2% vs. 90.7%:9.3%; Pearson’s χ2 test 1.755, ns). These relations showed only tendentious association in the SLE group (81.6%:18.7% vs. 90.7%:9.3%; Pearson’s χ2 2.811, p=0.094, ns.) There was not any significant correlation between the investigated MCP-1- 2518 G/A and the T-bet 310 C/G polymorphisms and the TNF-α -308 G/A and -238 allele polymorphisms. The frequency of T-bet was equal in relation with heterozygous (CG) to wild CC genotype in the investigated two autoimmune disorders. The GG homozygous genotype for T-bet could not be found in SLE and pSS groups, likely to be a protective factor. CONCLUSIONS - The above mentioned polymorphisms didn’t show any significant correlation with TNF-α -308 and -238 allele polymorphisms. The further research of the MCP-1 G/A and T-bet C/G polymorphisms is important, because of their possible prognostic importance for SLE and pSS.]

Hungarian Immunology

[Detection of rare phospholipid/co-factor antibodies in lupus patients]

TARR Tünde, KISS Emese, BÓTYIK Balázs, TUMPEK Judit, SOLTÉSZ Pál, ZEHER Margit, SZEGEDI Gyula, LAKOS Gabriella

[OBJECTIVE - Was to detect the rare phospholipid/ co-factor autoantibodies in lupus patients. PATIENTS AND METHODS - In the present study, besides anti-cardiolipin and anti-β2-glycoprotein I, antibodies directed against phosphatidil-serine, protrombin and annexinV were measured by commercial ELISA kits in 85 randomly selected lupus patients, 14 of whom met the criteria of antiphospholipid syndrome. Corralations were determined between the presence and concentration of rare antiphospholipids and those included in the diagnostic criteria of antiphospholid syndrome, as well as with clinical thrombotic manifestations. RESULTS - Anti-cardiolipin IgG was positive in 14 patients, aCL IgM in eight, anti-β2GPI IgG in four and IgM in five patients. Lupus anticoagulant was detected in nine cases. Seven patients were positive for anti-phosphatidilserine IgG, nine for aPS IgM, anti-protrombin IgG was positive in nine cases. Antiprotrombin IgM and anti-annexinV were negative in all patients. Correlation was found between antiphosphatidilserine and anti-cardiolipin antibodies. The frequency and the concentration of rare antiphospholipid/ co-factor antibodies were higher in patients with secondray antiphospholipid syndrome. The presence of such rare antiphospholipid antibodies cumulated in patients with antiphospholipid syndrome. Their presence increased the frequency of thrombotic events in the entire study population, furthermore in those positive for lupus anticoagulant or anti-cardiolipin. CONCLUSIONS - The rare anti-phospholipid/cofactor antibodies were found in 12% of an unselected cohort of lupus patients. Their presence was more frequent in patients with secondary antiphospholipid syndrome, and further increased the risk of thrombotic complications.]