title: The role of infectious diseases in the catastrophic antiphospholipid syndrome.
abstract: Catastrophic antiphospholipid syndrome (CAPS), also called "Asherson syndrome", is a variant of the antiphospholipid syndrome (APS) that occurs in less than 1% of APS cases. The etiology of CAPS is uncertain; however, several triggering factors have been recognized. The most common of these are infectious diseases, particularly those of the respiratory tract. CAPS pathogenesis is incompletely understood, but several theories have been proposed, such as the molecular mimicry theory, which describes the production of anti-β2-glycoprotein I (GP1) antibody in response to infection. The process is complex and involves the activation of Toll-like receptor 4 (TLR-4), which triggers a cytokine storm, followed by endothelial alterations that induce a procoagulant state.
authors.affiliation: Systemic Autoimmune Diseases Research Unit, Instituto Mexicano del Seguro Social, Puebla, Mexico; Department of Rheumatology and Immunology, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico.
authors.forename: M
authors.initials: M
authors.lastname: Garcia-Carrasco
authors.affiliation: Systemic Autoimmune Diseases Research Unit, Instituto Mexicano del Seguro Social, Puebla, Mexico; Department of Rheumatology and Immunology, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico.
authors.forename: C
authors.initials: C
authors.lastname: Mendoza-Pinto
authors.affiliation: Systemic Autoimmune Diseases Research Unit, Instituto Mexicano del Seguro Social, Puebla, Mexico.
authors.forename: S
authors.initials: S
authors.lastname: Macias-Diaz
authors.affiliation: Research and Postgraduate Department, Medicine School Benemérita Universidad Autónoma de Puebla, Puebla, Mexico.
authors.forename: F
authors.initials: F
authors.lastname: Vazquez de Lara
authors.affiliation: Systemic Autoimmune Diseases Research Unit, Instituto Mexicano del Seguro Social, Puebla, Mexico.
authors.forename: I
authors.initials: I
authors.lastname: Etchegaray-Morales
authors.affiliation: Department of Allergology, ISSSTE Regional, Puebla, Mexico.
authors.forename: J L
authors.initials: JL
authors.lastname: Galvez-Romero
authors.affiliation: Puebla Research Coordination, Instituto Mexicano del Seguro Social, Puebla, Mexico.
authors.forename: S
authors.initials: S
authors.lastname: Mendez-Martinez
authors.affiliation: Department of Autoimmune Diseases, Institut Clínic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Catalonia, Spain. Electronic address: rcervera@clinic.cat.
authors.forename: R
authors.initials: R
authors.lastname: Cervera
mesh_terms: D000818:Animals; D016736:Antiphospholipid Syndrome / Q000276:immunology*; D006801:Humans; D007239:Infections / Q000150:complications; D018716:Molecular Mimicry; D051197:Toll-Like Receptor 4 / Q000276:immunology; D053482:beta 2-Glycoprotein I / Q000276:immunology
chemical_list: C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4; D053482:beta 2-Glycoprotein I
keywords: Antibiotic; Asherson syndrome; Catastrophic antiphospholipid syndrome; Cytokine storm; Infection; Molecular mimicry; Toll-like receptor 4; β2-glycoprotein I