title: The relevance of "non-criteria" clinical manifestations of antiphospholipid syndrome: 14th International Congress on Antiphospholipid Antibodies Technical Task Force Report on Antiphospholipid Syndrome Clinical Features.
abstract: The purpose of this task force was to critically analyze nine non-criteria manifestations of APS to support their inclusion as APS classification criteria. The Task Force Members selected the non-criteria clinical manifestations according to their clinical relevance, that is, the patient-important outcome from clinician perspective. They included superficial vein thrombosis, thrombocytopenia, renal microangiopathy, heart valve disease, livedo reticularis, migraine, chorea, seizures and myelitis, which were reviewed by this International Task Force collaboration, in addition to the seronegative APS (SN-APS). GRADE system was used to evaluate the quality of evidence of medical literature of each selected item. This critical appraisal exercise aimed to support the debate regarding the clinical picture of APS. We found that the overall GRADE analysis was very low for migraine and seizures, low for superficial venous thrombosis, thrombocytopenia, chorea, longitudinal myelitis and the so-called seronegative APS and moderate for APS nephropathy, heart valve lesions and livedo reticularis. The next step can be a critical redefinition of an APS gold standard, for instance derived from the APS ACTION registry that will include not only current APS patients but also those with antiphospholipid antibodies not meeting current classification criteria.
authors: Disciplina de Reumatologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: mirhelen.abreu@gmail.com.
authors: Mirhelen M
authors: MM
authors: Abreu
authors: Serviço de Reumatologia, Hospital do Servidor Estadual do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Adriana
authors: A
authors: Danowski
authors: Vascular Medicine Division and Regional Competence Centre For Rare Vascular and Systemic Autoimmune Diseases, Centre Hospitalier Universitaire (CHU), Nancy, France; Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu, Vandoeuvre-les-Nancy, France; Institut National de la Santé et de la Recherche Médicale (INSERM), U1116, Vandoeuvre-les-Nancy Cedex, France.
authors: Denis G
authors: DG
authors: Wahl
authors: ABC Medical Center, México City, Mexico.
authors: Mary-Carmen
authors: MC
authors: Amigo
authors: First Department of Internal Medicine, University of Athens, Athens, Greece.
authors: Maria
authors: M
authors: Tektonidou
authors: Serviço de Reumatologia, Hospital do Servidor Estadual do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Marcelo S
authors: MS
authors: Pacheco
authors: Pedro Ernesto University Hospital of the Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Norma
authors: N
authors: Fleming
authors: New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA.
authors: Vinicius
authors: V
authors: Domingues
authors: Centro di Ricerche di Immunopatologia e Documentazione su Malattie Rare and Università di Torino, Dipartimento di Scienze Cliniche e Biologiche, Torino, Italy; Graham Hughes Lupus Research Laboratory, King's College London, London, UK.
authors: Savino
authors: S
authors: Sciascia
authors: Rio de Janeiro Municipality, Rio de Janeiro, Brazil.
authors: Julia O
authors: JO
authors: Lyra
authors: Johns Hopkins University School of Medicine, Baltimore, USA.
authors: Michelle
authors: M
authors: Petri
authors: Lupus Research Unit at St Thomas' Hospital, London, UK.
authors: Munther
authors: M
authors: Khamashta
authors: Discipline of Rheumatology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Roger A
authors: RA
authors: Levy
mesh_terms: D000818:Animals; D017152:Antibodies, Antiphospholipid / Q000276:immunology*; D016736:Antiphospholipid Syndrome / Q000276:immunology* / Q000628:therapy; D002819:Chorea / Q000276:immunology; D006801:Humans; D009187:Myelitis / Q000276:immunology; D013921:Thrombocytopenia / Q000276:immunology; D016896:Treatment Outcome
chemical_list: D017152:Antibodies, Antiphospholipid
keywords: Accuracy; Antiphospholipid Syndrome; Clinical features; GRADE system; Non-criteria manifestations