title: The association of thrombocytopenia with systemic manifestations in the antiphospholipid syndrome.
abstract: Thrombocytopenia is frequently found in patients with the antiphospholipid syndrome (APS), yet data concerning clinical associations of thrombocytopenia in patients with APS are still scarce. We evaluated possible associations between thrombocytopenia and various APS-related manifestations in a large group of APS patients. Three hundred and seven APS patients were retrospectively evaluated, 259 women and 48 men. Most patients had primary APS (PAPS) (n=173, 56.1%). APS was associated with systemic lupus erythematosus (SLE) in 104 patients (33.9%). All patients underwent detailed medical interview and routine physical examination. Further data were obtained from patients' medical files regarding the expression of various clinical manifestations of the disease. There were 90 patients with thrombocytopenia (29.3%), the rate was significantly higher in SLE compared to PAPS patients (41.9% vs. 23.1%, p=0.001). Similar rates of thrombocytopenia were found in male (29.2%) and female (29.3%) patients. Significant associations were found between thrombocytopenia and cardiac valves thickening and dysfunction, epilepsy, chorea, arthritis, livedo reticularis and skin ulcerations. In contrast, the rates of thrombotic episodes as well as obstetric complications were similar in patients with and without thrombocytopenia. Our data suggest the presence of thrombocytopenia may be a risk factor for cardiac, neurological, articular and cutaneous complications in APS.
authors.affiliation: Research Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 52621, Israel.
authors.forename: Ilan
authors.initials: I
authors.lastname: Krause
authors.forename: Miri
authors.initials: M
authors.lastname: Blank
authors.forename: Abigail
authors.initials: A
authors.lastname: Fraser
authors.forename: Margalit
authors.initials: M
authors.lastname: Lorber
authors.forename: Ludmilla
authors.initials: L
authors.lastname: Stojanovich
authors.forename: Josef
authors.initials: J
authors.lastname: Rovensky
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: D000026:Abortion, Habitual / Q000209:etiology; D000328:Adult; D000368:Aged; D017153:Antibodies, Anticardiolipin / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000453:epidemiology; D001168:Arthritis / Q000209:etiology; D002819:Chorea / Q000209:etiology; D004827:Epilepsy / Q000209:etiology; D005260:Female; D006023:Glycoproteins / Q000097:blood / Q000276:immunology; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood / Q000276:immunology; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000209:etiology; D012189:Retrospective Studies; D012871:Skin Diseases / Q000209:etiology; D013921:Thrombocytopenia / Q000150:complications* / Q000453:epidemiology; D013927:Thrombosis / Q000209:etiology; D053482:beta 2-Glycoprotein I
chemical_list: D017153:Antibodies, Anticardiolipin; D006023:Glycoproteins; D016682:Lupus Coagulation Inhibitor; D053482:beta 2-Glycoprotein I