Thrombosis in Autoimmune Diseases: A Role for Immunosuppressive Treatments?
Autoimmune diseases are not infrequently associated with arterial or venous thrombotic events. Chronic inflammation and immune system impairment are considered the main pathogenetic mechanisms. Some of the drugs used in the treatment of such diseases have been associated with an increased risk of thrombosis. On the contrary, their anti-inflammatory and immune modulator activity could correct some mechanisms leading to thrombosis. In this review, recent evidence available on this topic is examined. There is a lack of adequate studies, but available evidence suggests that glucocorticoids and high-dose immunoglobulins are associated with an increased incidence of venous thromboembolism. Although available data do not allow drawing definite conclusions and more data are needed from future studies and registries, physicians should be aware of these associations.
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Elena
E
Silvestri
Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Naples, Italy.
Antonella
A
Scalera
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Giacomo
G
Emmi
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Danilo
D
Squatrito
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Lucia
L
Ciucciarelli
SOD Interdisciplinary Internal Medicine, Center for Autoimmune Systemic Diseases-Behçet Center and Lupus Clinic-AOU Careggi Hospital of Florence, Florence, Italy.
Caterina
C
Cenci
SOD Interdisciplinary Internal Medicine, Center for Autoimmune Systemic Diseases-Behçet Center and Lupus Clinic-AOU Careggi Hospital of Florence, Florence, Italy.
Carlo
C
Tamburini
SOD Interdisciplinary Internal Medicine, Center for Autoimmune Systemic Diseases-Behçet Center and Lupus Clinic-AOU Careggi Hospital of Florence, Florence, Italy.
Lorenzo
L
Emmi
Department of Clinical Medicine and Surgery, Federico II University Medical School of Naples, Naples, Italy.
Giovanni
G
Di Minno
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Domenico
D
Prisco
D001327:Autoimmune Diseases / Q000097:blood / Q000188:drug therapy / Q000276:immunology; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007136:Immunoglobulins / Q000009:adverse effects* / Q000627:therapeutic use; D054556:Venous Thromboembolism / Q000097:blood / Q000139:chemically induced / Q000276:immunology; D020246:Venous Thrombosis / Q000097:blood / Q000139:chemically induced / Q000276:immunology
D005938:Glucocorticoids; D007136:Immunoglobulins