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Risk of thrombosis, pregnancy morbidity or death in antiphospholipid antibodies positive patients with or without thrombocytopenia

  • Thomas Moulinet
    Affiliations
    Department of Internal Medicine and Clinical Immunology, Regional Competence Center for Rare and Systemic Autoimmune Disease, Nancy University Hospital, Vandœuvre-lès-Nancy, France

    Université de Lorraine, Vandœuvre-lès-Nancy, France
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  • Virginie Dufrost
    Affiliations
    Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, Nancy University Hospital, Vandœuvre-lès-Nancy, France

    Université de Lorraine, Vandœuvre-lès-Nancy, France
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  • Isabelle Clerc-Urmès
    Affiliations
    Methodology, data management and statistics Unit, MPI department, Nancy University Hospital, Vandœuvre-lès-Nancy, France
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  • Denis Wahl
    Affiliations
    Université de Lorraine, Vandœuvre-lès-Nancy, France

    Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, Nancy University Hospital, Vandœuvre-lès-Nancy, France

    INSERM, UMR_S 1116, Vandœuvre-lès-Nancy, France
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  • Stéphane Zuily
    Correspondence
    Corresponding author at: Service de Médecine Vasculaire, Centre de Compétence des Maladies Rares Vasculaires, Systémiques et Auto-Immunes, Institut Louis Mathieu, CHRU de Nancy, Rue du Morvan, F-54511 Vandoeuvre-lès-Nancy Cedex, France.
    Affiliations
    Université de Lorraine, Vandœuvre-lès-Nancy, France

    Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, Nancy University Hospital, Vandœuvre-lès-Nancy, France

    INSERM, UMR_S 1116, Vandœuvre-lès-Nancy, France
    Search for articles by this author
Published:October 17, 2020DOI:https://doi.org/10.1016/j.ejim.2020.10.011
      Antiphospholipid syndrome (APS) is an immune-mediated acquired disorder characterized by venous, arterial or small vessels thromboses and/or obstetrical morbidity, and the persistent presence of antiphospholipid antibodies (APL). APS is also associated with other “non-criteria” manifestations [
      • Erkan D
      • Lockshin MD
      Non-criteria manifestations of antiphospholipid syndrome.
      ], of which thrombocytopenia is the most frequent, present in up to 29% of SLE-associated APS patients [
      • Chock YP
      • Moulinet T
      • Dufrost V
      • Erkan D
      • Wahl D
      • Zuily S
      Antiphospholipid antibodies and the risk of thrombocytopenia in patients with systemic lupus erythematosus: a systematic review and meta-analysis.
      ].Thrombocytopenia is thought to be due to peripheral platelet consumption and/or destruction subsequently to their activation by APL. In addition, platelets may play a central role in APS, as they have been shown to be the main target of anti- β2GPI / β2GPI complexes [
      • Proulle V
      • Furie RA
      • Merrill-Skoloff G
      • Furie BC
      • Furie B
      Platelets are required for enhanced activation of the endothelium and fibrinogen in a mouse thrombosis model of APS.
      ], and their therapeutic inhibition seems to be effective in preventing thrombosis [
      • Arnaud L
      • Mathian A
      • Devilliers H
      • Ruffatti A
      • Tektonidou M
      • Forastiero R
      • Pengo V
      • Lambert M
      • Lefevre G
      • Martinez-Zamora MA
      • Balasch J
      • Wahl D
      • Amoura Z
      Patient-level analysis of five international cohorts further confirms the efficacy of aspirin for the primary prevention of thrombosis in patients with antiphospholipid antibodies.
      ].

      Keywords

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