[Antiphospholipid syndrome. 20 cases].
OBJECTIVE
We analyzed the clinical and biological characteristics as well as the clinical course and outcome observed in 20 patients with antiphospholipid antibodies and clinical signs including thrombosis or repeated spontaneous abortion to better identify the recently described antiphospholipid syndrome.


METHODS
We retrospectively studied all patients observed in our unit from 1981 to 1992 who fulfilled the following inclusion criteria: a) at least one episode of arterial or venous thrombosis and/or repeated spontaneous abortions, b) positive for antiphospholipid antibodies.


RESULTS
Twenty patients were included, 3 with systemic lupus erythematosus (according to the American Rheumatism Association criteria). Arterial or venous thrombosis occurred in 9 and 16 respectively, including exceptional cases of cerebral phlebitis and thrombosis of dermal capillaries. High blood pressure was recorded in 8. Only 1 or 2 types of antiphospholipid antibodies were found in most patients. Anticardiolipin, a circulating anticoagulant and a false-positive Bordet-Wassermann reaction were found together in only 3 out of 16. In addition, the antibody level varied independently from the thrombotic events. There was no case with a clinical course from primary antiphospholipid syndrome to systemic erythromatosus lupus. The effect to treatment on occurrence of new thrombotic events was studied. Three patients suffered one or more haemorrhagic events during antivitamin K treatment.


CONCLUSIONS
It is difficult to establish a differentiation between primary antiphospholipid syndrome, systemic lupus erythematosus and lupus-like syndromes, and precise methods of identifying antiphospholipid antibodies should be further developed.
Service de Médecine interne, Centre médico-chirurgical Foch, Suresnes.
A M
AM
Piette
J J
JJ
Mourad
M
M
Karmochkine
D
D
Didon
P
P
Gepner
P
P
Graveleau
D
D
Grenet
L J
LJ
Couderc
A
A
Chapman
D015110:4-Hydroxycoumarins; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000276:immunology; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007192:Indenes; D002542:Intracranial Embolism and Thrombosis / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000209:etiology*; D012189:Retrospective Studies; D013924:Thrombophlebitis / Q000188:drug therapy / Q000209:etiology*; D014812:Vitamin K / Q000037:antagonists & inhibitors* / Q000627:therapeutic use
D015110:4-Hydroxycoumarins; D000305:Adrenal Cortex Hormones; D000925:Anticoagulants; D007192:Indenes; C011664:antivitamins K; D014812:Vitamin K
Syndrome des antiphospholipides. 20 observations.