Manifestation of Antiphospholipid Syndrome among Saudi patients :examining the applicability of sapporo Criteria

Size: px
Start display at page:

Download "Manifestation of Antiphospholipid Syndrome among Saudi patients :examining the applicability of sapporo Criteria"

Transcription

1 Manifestation of Antiphospholipid Syndrome among Saudi patients :examining the applicability of sapporo Criteria Farjah H AlGahtani Associate professor,md,mph Leukemia,Lymphoma in adolescent,thromboembolic Disease Oncology Center, King Saud University

2 OUTLINE : Historical Back ground of APS APS Morbidity Pathogenesis Sign and symptoms of APS Clinical criteria of APS APS in Saudia Arabia

3 Circulating anticoagulants in SLE are named lupus anticoagulants ( LA) because they prolong the clotting times in phospholipid dependent assays.la believed to cause clinical hemorrhagic disease 1963 LA are reported by Bowie et al to be associated with thrombosis in SLE patients LA are identified by Harris et al to be antibodies that react with cardiolipin Lupus anticoagulants react with purified cardiolipin and they are identified as anticardiolipin antibodies by RIA

4 1963 Edward John Walter Bowie, MD Mayo Medical School identified APS as an acquired thrombophilia 1984 Graham Robert Vivian Hughes MD FRCP. St Thomas Hospital UK identified APS as a generalized autoimmune disorder hassouna

5 Hughes syndrome

6

7

8 who symptoms conferences membership news we are what diagnosis publications fundraising events we do treatment patient shop research FAQs research activities publicity prognosis Hassouna February 2,

9 Antiphospholipid antibodies the most significant target antigen is the Beta 2 glycoprotein-1 In 1990 Monica Galli and her group in Bergamo, Italy reported that the true antigenic targets of antiphospholipid antibodies are not the phospholipids but a plasma protein beta 2 glycoprotein-1 bound to an anionic surface. Galli M,Comfurius P, Massen C et al. Anticardiolipin antibodies (ACA) directed not to cardiolipin but to a plasma protein co-factor. Lancet 1990;334:

10 APS morbidity APS is the most common cause of acquired thrombophilia. Prevalence in general population: 2-4% 15-20% of all DVT with or without PE. 1/3 of new strokes in patients < 50 years age % women with recurrent pregnancy losses. APS: significant proportion of thromboembolic disease and pregnancy loss in SLE. APL Abs present in 30-40% SLE. One third of those patients have clinical manifestations of APS. acl positivity may precede a more severe form of SLE.

11 PATHOGENESIS

12 Two mechanisms are identified in the induction of autoimmune Antiphospholipid antibodies (a PL). Apoptotic phospholipid beta 2 glycoprotein-1 complexes. Phospholipids released from injured cells bound to beta 2 glycoprotein 1 Infection related antiphospholipid antibodies. From experiments in mice, antiphospholipid antibodies are produced by binding of beta2-glycoprotein 1 to phospholipid viral or bacterial proteins by molecular mimicry

13 Listen to your patients, he is telling you the diagnosis

14

15 Multiple Strokes in a Young Woman (Brain MRI) Occlusion of Right Middle Cerebral Artery In a 3 Years Old Child with Severe Headache and Hemiparesis With acl Antibodies +

16 Other recognized features of APS Thrombocytopenia Haemolytic anaemia Livedo reticularis Cerebral involvement Heart valve disease Hypertension Pulmonary hypertension Leg ulcers Epilepsy, cerebral infarction, chorea and migraine, transverse myelopathy/myelitis mitral valve

17 1000 patients with APS Deep vein thrombosis / PE 48% Pregnancy loss 35% Thrombocytopenia 30% Livedo reticularis 24% Stroke / TIA 20% Superficial thrombophlebitis 9% Hemolytic anemia 7% Cervera et al. Arthritis Rheum 2002

18 Antiphospholipid syndrome Thrombotic events n = 1000 over 10 years Baseline 10 years DVT 39% 4% Stroke/TIAs 31% 9% Pulmonary emboli 14% 4% Myocardial infarction 6% 2% Cervera R et al Ann Rheum Dis 2015;74:1011

19 Antiphospholipid syndrome Obstetric manifestations n = 1000 over 10 years Baseline 10 years Pre-eclampsia 5% 6% Early pregnancy loss < 10 wks 35% 17% Late pregnancy loss 10 wks 17% 5% Live birth with prematurity 11% 48% Live birth with IUGR 2% 26% Cervera R et al Ann Rheum Dis 2015;74:1011

20 Clinical criteria for the diagnosis of APS Thrombosis Pregnancy morbidity Venous Arterial Small vessel (e.g. thrombotic microangiopathy in kidney) 3 consecutive miscarriages (<10 weeks' gestation) 1 fetal death (>10 weeks' gestation with normal fetal morphology) 1 premature birth (<34 weeks' gestation with normal fetal morphology) due to pre-eclampsia or severe placental insufficiency.

21 Diagnosis Of APS Anticardiolipin antibodies are measured using commercially available enzyme-linked immunosorbent assay (ELISA) kits. Medium or high titres of IgG or IgM are required. Firm diagnosis of APS requires two or more positive readings for LA and/or acl at least 6-12weeks apart, plus at least one of the clinical criteria listed before.

22

23

24

25

26

27

28 Clinical and Laboratory Manifestations of Antiphospholipid Syndrome Among Saudi Patients: Examining the Applicability of Sapporo Criteria Farjah Al-Qahtani 1, Abdulrahman S. Arfaj 2, Sayedah Asfar 2 and Mohammed A. Omair 2 1 Division of Hematology, Department of Medicine, King Saud University, Riyadh, Saudi Arabia 2 Division of Rheumatology, Department of Medicine, King Saud University, Riyadh, Saudi Arabia Background Results Conclusion Antiphospholipid syndrome (APS) is a systematic autoimmune disease featured with vascular thrombosis and pregnancy morbidity. The revised Sapporo criteria are widely used classification criteria for APS. Objectives This study aims to examine clinical and serological manifestations of a cohort of Saudi APS patients. To examine the applicability of revised Sapporo criteria in this cohort. Method This was a single center, retrospective study. Data were collected from the records of APS patients in King Saud University Medical City. The Sapporo criteria were applied and divided patients into definitive APS cases (fulfilled the criteria) and possible APS cases (failed the criteria). Independent sample T-test was used to examine the difference in clinical and laboratory manifestations and comorbidities between the two group. Logistic regression was used to examine the association between Sapporo criterial fulfillment and major clinical manifestations. A total of 72 (90%) females were included. The mean (±SD) age at diagnosis was 28.1 (± 8.7) years. 22 patients (27.5%) fulfilled the revised Sapporo criteria (definitive APS). There was no significant difference in the clinical manifestations or treatment between the two group (p>0.2). Most patients did not fulfill the revised Sapporo criteria. Our study identified a gap in applying these criteria in Saudi patients. Future studies of examining the diagnostic validity of APS laboratory manifestations are needed Table 2. The serology results of the possible APS patients in relation to their clinical manifestations (N=58) Serology Thrombosis 2 Pregnancy morbidity 3 Thrombocytopenia 4 Asymptomatic Total +ve 5 acl 7 (22.6) 12 (40) 3 (42.9) 6 (75) 28 (48.3) +ve LA 1 3 (9.7) 2 (6.7) 1 (14.3) 2 (25) 8 (13.8) -ve 21 (67.7) 16 (53.3) 3 (42.9) - 40 (69.0) Total Figure 1. The age distribution of definitive and possible APS cases Table 1. Study population characteristics Total (%, N=80) Definitive APS (%, N=22) Possible APS (%, N=58) P value Age at diagnosis, yr 28.5 (8.8) 29.7 (9.3) 28.1 (8.7) 0.46 Year at diagnosis 2002 (4) 2001 (4) 2002 (4) 0.6 Female 72 (90) 18 (81.8) 54 (93.1) 0.13 Table 3. The association of Sapporo criteria fulfillment with major clinical manifestations Nationality (Saudi) 71 (88.8) 18 (81.8) 53 (91.4) 0.23 Complications (Y/N) 10 (12.5) 6 (27.3) 4 (6.9) Follow-up response Remission without recurrent event 30 (37.5) 8 (36.4) 22 (37.9) Model 1 Model 2 Model 3 OR (95% CI) P value OR (95% CI) P value OR (95% CI) P value Vascular thrombosis 1.87 (0.66, 5.25) (0.55, 4.65) (0.55, 4.71) 0.39 DVT or PE (0.68, 4.92) (0.55, 4.32) (0.55, 4.31) 0.42 Recurrent 2 DVT or PE 0.65 (0.15, 2.79) (0.14, 4.21) (0.12, 3.81) 0.65 Recurrent event 14 (17.5) 4 (18.2) 10 (17.2) Single visit 35 (43.8) 10 (45.5) 25 (43.1) Died 1 (1.25) 0 (0) 1 (1.72) 0.94 Pregnancy morbidity 0.53 (0.19, 1.46) (0.21, 1.84) (0.21, 1.92) 0.42 Model 1: crude associations Model 2: adjusted for age at diagnosis, gender, nationality Model 3: adjusted for covariates in model 2 and follow-up response 1 DVT: deep vein thrombosis; PE: pulmonary embolism 2 Analysis for recurrent DVT or PE was restricted to 35 patients with previous DVT or PE event

29

30

31 Lessons learned Diagnosis is absolutely necessary for the proper clinical management Lupus Anticoagulant is the identifier or biomarker unique to the Antiphospholipid syndrome and consider the Auto-antibodies that prolong clotting times in phospholipid dependent clotting assays are termed lupus anticoagulant

32 Special Coagulation Laboratory Recipe for APS diagnosis APTT clotting times must be prolonged at least twice control plasma clotting times (correlates with high antibody titer) APTT prolonged clotting times does not correct in mixing patient plasma with pooled normal plasma ELISA identifies beta2-glycoprotein 1 antigen and autoantibodies. Testing is repeated as indicated. APS induced by viral or bacterial proteins disappears after infection is cured

33 SAUDI-APS RESEARCH GRUOP

34 AIMS of THE Saudi APS-Research Group : Describe outcomes of arterial venous and pregnancy complications. Describe CAPS presentation in Saudi Population and the outcome. Assess drug respond in APS. assess quality of life / depression in APS patients Role of genetics Factors of APS including familial and sporadic cases Develop an APS registry and maybe guidelines under the hematology society We need to manage getting different national /international collaboration Centers onboard.

35 THANK YOU

Antiphospholipid Syndrome ( APS)

Antiphospholipid Syndrome ( APS) Antiphospholipid Syndrome ( APS) Edward John Walter Bowie, MD Mayo Medical School the first to identify APS as an acquired thrombophilia Graham Robert Vivian Hughes MD FRCP Unit Rayne Institute St Thomas

More information

The Antiphospholipid Syndrome

The Antiphospholipid Syndrome The Antiphospholipid Syndrome 1 / 6 2 / 6 3 / 6 The Antiphospholipid Syndrome Antiphospholipid antibody syndrome (commonly called antiphospholipid syndrome or APS) is an autoimmune disease present mostly

More information

Sindrome da anticorpi antifosfolipidi: clinica e terapia. Vittorio Pengo Clinical Cardiology, Padova, Italy

Sindrome da anticorpi antifosfolipidi: clinica e terapia. Vittorio Pengo Clinical Cardiology, Padova, Italy Sindrome da anticorpi antifosfolipidi: clinica e terapia Vittorio Pengo Clinical Cardiology, Padova, Italy Revised Classification Criteria for the Antiphospholipid Syndrome J Thromb Haemost 2006;4:295-306

More information

Antiphospholipid Syndrome Handbook

Antiphospholipid Syndrome Handbook Antiphospholipid Syndrome Handbook Maria Laura Bertolaccini, Oier Ateka-Barrutia, and Munther A. Khamashta Antiphospholipid Syndrome Handbook Maria Laura Bertolaccini, MD, PhD Lupus Research Unit The Rayne

More information

Are there still any valid indications for thrombophilia screening in DVT?

Are there still any valid indications for thrombophilia screening in DVT? Carotid artery stenosis and risk of stroke Are there still any valid indications for thrombophilia screening in DVT? Armando Mansilha MD, PhD, FEBVS Faculty of Medicine of University of Porto Munich, 2016

More information

Thrombophilia. Dr. A Sarrafnejad PhD Dep. Immunology School of public health TUMS

Thrombophilia. Dr. A Sarrafnejad PhD Dep. Immunology School of public health TUMS Autoimmune Thrombophilia Dr. A Sarrafnejad PhD Dep. Immunology School of public health TUMS Saraf@sina.tums.ac.ir Acquired Thrombophilia HIT PNH Cyckle cell Anemia Myeloproliferative lf Diseases Thrombocytosis

More information

Antiphospholipid antibodies

Antiphospholipid antibodies CARDIOLOGY PATIENT PAGE CARDIOLOGY PATIENT PAGE Antiphospholipid Antibodies Caron P. Misita, PharmD; Stephan Moll, MD Antiphospholipid antibodies (APLAs) are proteins that may be present in the blood and

More information

Anti β 2. -Glycoprotein I and Antiphosphatidylserine Antibodies Are Predictors of Arterial Thrombosis in Patients With Antiphospholipid Syndrome

Anti β 2. -Glycoprotein I and Antiphosphatidylserine Antibodies Are Predictors of Arterial Thrombosis in Patients With Antiphospholipid Syndrome Coagulation and Transfusion Medicine / PREDICTIVE VALUE OF ANTIPHOSPHOLIPID ANTIBODIES Anti β -Glycoprotein I and Antiphosphatidylserine Antibodies Are Predictors of Arterial Thrombosis in Patients With

More information

AN INTERESTING CASE OF RESPIRATORY DISTRESS. Dr.V.Akila Devi DNB PG Southern Railway Headquarters Hospital Chennai

AN INTERESTING CASE OF RESPIRATORY DISTRESS. Dr.V.Akila Devi DNB PG Southern Railway Headquarters Hospital Chennai AN INTERESTING CASE OF RESPIRATORY DISTRESS Dr.V.Akila Devi DNB PG Southern Railway Headquarters Hospital Chennai 11 month old female infant 1 st born to parents of NC marriage referred from Kolkatta H/O:

More information

DISCLOSURE. Presented by: Merav Sendowski, MD Oregon Health and Science University

DISCLOSURE. Presented by: Merav Sendowski, MD Oregon Health and Science University Thrombophilia! DISCLOSURE Presented by: Merav Sendowski, MD Oregon Health and Science University Created by: Thomas Deloughery, MD Oregon Health and Science University Current Relevant Financial Relationship(s)

More information

Thrombophilia: To test or not to test

Thrombophilia: To test or not to test Kenneth Bauer, MD Harvard Medical School, Boston, MA Professor of Medicine VA Boston Healthcare System Chief, Hematology Section Beth Israel Deaconess Medical Center, Boston, MA Director, Thrombosis Clinical

More information

Case Report Lower Limb Ischemia: Aortoiliac Thrombosis Related to Antiphospholipid Syndrome (APS) Case Report and Review of the Literature

Case Report Lower Limb Ischemia: Aortoiliac Thrombosis Related to Antiphospholipid Syndrome (APS) Case Report and Review of the Literature Case Reports in Surgery Volume 2013, Article ID 536971, 4 pages http://dx.doi.org/10.1155/2013/536971 Case Report Lower Limb Ischemia: Aortoiliac Thrombosis Related to Antiphospholipid Syndrome (APS) Case

More information

DOWNLOAD OR READ : POSITIVE OPTIONS FOR ANTIPHOSPHOLIPID SYNDROME APS SELF HELP AND TREATMENT PDF EBOOK EPUB MOBI

DOWNLOAD OR READ : POSITIVE OPTIONS FOR ANTIPHOSPHOLIPID SYNDROME APS SELF HELP AND TREATMENT PDF EBOOK EPUB MOBI DOWNLOAD OR READ : POSITIVE OPTIONS FOR ANTIPHOSPHOLIPID SYNDROME APS SELF HELP AND TREATMENT PDF EBOOK EPUB MOBI Page 1 Page 2 positive options for antiphospholipid syndrome aps self help and treatment

More information

Antiphospholipid Syndrome

Antiphospholipid Syndrome Antiphospholipid Syndrome EliA Cardiolipin and EliA β2-glycoprotein I Fully Automated Testing for Antiphospholipid Syndrome (APS) Testing for APS according to classification criteria determination of anti-β2-glycoprotein

More information

Lupus Anticoagulants (LA), Antiphospholipid (APL) Antibodies & APL Syndrome: Review & Update. Antiphospholipid. Antiphospholipid

Lupus Anticoagulants (LA), Antiphospholipid (APL) Antibodies & APL Syndrome: Review & Update. Antiphospholipid. Antiphospholipid , Antiphospholipid (APL) Antibodies & APL Syndrome: Review & Update William L. Nichols, MD Mayo Clinic College of Medicine Rochester, Minnesota USA Disclosures & Objectives (Nichols) Disclosures Relevant

More information

Key words: antiphospholipid syndrome, trombosis, pathogenesis

Key words: antiphospholipid syndrome, trombosis, pathogenesis 26. XI,. 4/2011,.,..,..,., -..,,. 2GPI. -,.,,., -,, -, -,,,,, IL-1, IL-2, IL-6, IL-8, IL-12, IL-10, TNF, INF-. :,, N. Stoilov, R. Rashkov and R. Stoilov. ANTIPHOSPHOLIPID SYNDROME HISTORICAL DATA, ETI-

More information

Daniel Egan, MD April 13, 2012

Daniel Egan, MD April 13, 2012 Daniel Egan, MD April 13, 2012 Aug 2006 (at age 15): Acute unprovoked DVT in left common femoral vein Factor V Leiden heterozygous Positive lupus inhibitor Lovenox BID 2 weeks later: increased clot burden,

More information

Antiphospholipid Antibody Syndrome: Management Issues for the Hematologist

Antiphospholipid Antibody Syndrome: Management Issues for the Hematologist Antiphospholipid Antibody Syndrome: Management Issues for the Hematologist Wisconsin Institute of Discovery Karen Rossi/Bristol-Myers Squibb Morey A. Blinder, MD Washington University, St. Louis, MO March

More information

Prevalence of antiphospholipid auto antibodies in patients with thrombosis

Prevalence of antiphospholipid auto antibodies in patients with thrombosis EUROPEAN ACADEMIC RESEARCH Vol. IV, Issue 6/ September 2016 ISSN 2286-4822 www.euacademic.org Impact Factor: 3.4546 (UIF) DRJI Value: 5.9 (B+) Prevalence of antiphospholipid auto antibodies in patients

More information

Patient with Musculo-skeletal Complaints - Summary

Patient with Musculo-skeletal Complaints - Summary Patient with Musculo-skeletal Complaints - Summary 1. Soft Tissue Rheumatism or Arthritis 2. Arthritis Monoarticular Polyarticular - :- (Asymmetrical) (Symetrical) :- -Crystals, Gout - Infective acute

More information

Current View of the Treatment of Antiphospholipid Syndrome

Current View of the Treatment of Antiphospholipid Syndrome GROUPE HOSPITALIER PITIE SALPETRIERE Current View of the Treatment of Antiphospholipid Syndrome Pr Zahir AMOURA Department of Internal Medicine French National Reference center for SLE and APS Hôpital

More information

ANTIPHOSPHOLIPID (HUGHES) SYNDROME

ANTIPHOSPHOLIPID (HUGHES) SYNDROME 1 ANTIPHOSPHOLIPID (HUGHES) SYNDROME INTRODUCTION In 1983, Hughes et al describe a syndrome characterized by arterial and venous thrombosis, recurrent foetal wastage, and thrombocytopenia, which were seen

More information

Antiphospholipid Syndrome and Vascular Ischemic (Occlusive) Diseases: An Overview

Antiphospholipid Syndrome and Vascular Ischemic (Occlusive) Diseases: An Overview Yonsei Med J 48(6):901-926, 2007 DOI 10.3349/ymj.2007.48.6.901 Antiphospholipid Syndrome and Vascular Ischemic (Occlusive) Diseases: An Overview Penka A. Atanassova Department of Neurology, Medical University,

More information

Epidemiologia e clinica del tromboembolismo venoso. Maria Ciccone Sezione di Ematologia e Fisiopatologia della Coagulazione

Epidemiologia e clinica del tromboembolismo venoso. Maria Ciccone Sezione di Ematologia e Fisiopatologia della Coagulazione Epidemiologia e clinica del tromboembolismo venoso Maria Ciccone Sezione di Ematologia e Fisiopatologia della Coagulazione Thrombophilia may present clinically as one or more of several thrombotic manifestations

More information

Thrombophilia. Stephan Moll, MD Medicine, Heme-Coag UNC Chapel Hill, NC. GASCO Atlanta Sept 8 th, Disclosures. Conflicts of interest: NONE

Thrombophilia. Stephan Moll, MD Medicine, Heme-Coag UNC Chapel Hill, NC. GASCO Atlanta Sept 8 th, Disclosures. Conflicts of interest: NONE LA APLA 1 3 ACA Anti-ß2-GP I 2 45 Thrombophilia Stephan Moll, MD Medicine, Heme-Coag UNC Chapel Hill, NC GASCO Atlanta Sept 8 th, 2017 Disclosures Conflicts of interest: NONE Off-label product use discussion:

More information

Clinical and immunological characteristics of antiphospholipid syndrome in an Asian population: a retrospective study

Clinical and immunological characteristics of antiphospholipid syndrome in an Asian population: a retrospective study Asian Pacific Journal of Allergy and Immunology ORIGINAL ARTICLE Clinical and immunological characteristics of antiphospholipid syndrome in an Asian population: a retrospective study Kanon Jatuworapruk,

More information

Lupus anticoagulant and anticardiolipin antibodies in SLE with secondary Antiphospholipid Antibody Syndrome

Lupus anticoagulant and anticardiolipin antibodies in SLE with secondary Antiphospholipid Antibody Syndrome Turk J Hematol 2007; 24:69-74 Turkish Society of Hematology RESEARCH ARTICLE Lupus anticoagulant and anticardiolipin antibodies in SLE with secondary Antiphospholipid Antibody Syndrome Shveta Garg, Annamma

More information

Anticardiolipin Antibodies in Patients With Type 2 Diabetes Mellitus

Anticardiolipin Antibodies in Patients With Type 2 Diabetes Mellitus CM&R Rapid Release. Published online ahead of print February 26, 2009 as doi:10.3121/cmr.2008.828 Original Research Anticardiolipin Antibodies in Patients With Type 2 Diabetes Mellitus José María Calvo-Romero,

More information

Anaesthesiologic management of a parturient with a known antiphospholipid syndrome

Anaesthesiologic management of a parturient with a known antiphospholipid syndrome Anaesthesiologic management of a parturient with a known antiphospholipid syndrome Pascal Vuilleumier Universitätsklinik für Anästhesie und Schmerztherapie Case presentation: Mrs A. B. 1975 Early monday

More information

Interactive Case Vignette: DOACs (Direct Oral Anti-Coagulants) vs. Warfarin for APLA (Anti-Phospholipid Antibody Syndrome)

Interactive Case Vignette: DOACs (Direct Oral Anti-Coagulants) vs. Warfarin for APLA (Anti-Phospholipid Antibody Syndrome) Interactive Case Vignette: DOACs (Direct Oral Anti-Coagulants) vs. Warfarin for APLA (Anti-Phospholipid Antibody Syndrome) Ara Metjian, MD Duke Debates Benign Hematologic Highlights April 22, 2017 Disclaimer

More information

APPENDIX 1 Eight New Cases of LAHS and Review of the Literature: Clinical and Laboratory Data

APPENDIX 1 Eight New Cases of LAHS and Review of the Literature: Clinical and Laboratory Data Supplementary Digital Content 1 Mazodier et al. Lupus Anticoagulant- Hypoprothrombinemia Syndrome: Report of 8 Cases and Review of the Literature Medicine (Baltimore). 2012;91(5). APPEDIX 1 Eight ew Cases

More information

T he antiphospholipid syndrome (APS) is a thrombophilic

T he antiphospholipid syndrome (APS) is a thrombophilic 1639 EXTENDED REPORT ntiphospholipid antibody tests: spreading the net M L ertolaccini, S Gomez, J F P Pareja, Theodoridou, G Sanna, G R V Hughes, M Khamashta... See end of article for authors affiliations...

More information

Should infants with perinatal thrombosis be screened for thrombophilia and treated by anticoagulants?

Should infants with perinatal thrombosis be screened for thrombophilia and treated by anticoagulants? Should infants with perinatal thrombosis be screened for thrombophilia and treated by anticoagulants? Shoshana Revel-Vilk, MD MSc Pediatric Hematology Center, Pediatric Hematology/Oncology Department,

More information

PD Dr. med. habil. Michaela Jaksch, Consultant Laboratory Medicine, Medical Director, Freiburg Medical Laboratory ME LLC, Dubai, UAE

PD Dr. med. habil. Michaela Jaksch, Consultant Laboratory Medicine, Medical Director, Freiburg Medical Laboratory ME LLC, Dubai, UAE Autoimmune Disorders in Gynecology/Obstetrics PD Dr. med. habil. Michaela Jaksch, Consultant Laboratory Medicine, Medical Director, Freiburg Medical Laboratory ME LLC, Dubai, UAE Abstract The spectrum

More information

Thrombophilia. Diagnosis and Management. Kevin P. Hubbard, DO, FACOI

Thrombophilia. Diagnosis and Management. Kevin P. Hubbard, DO, FACOI Thrombophilia Diagnosis and Management Kevin P. Hubbard, DO, FACOI Clinical Professor of Medicine Kansas City University of Medicine and Biosciences-College of Osteopathic Medicine Kansas City, Missouri

More information

ORIGINAL PAPERS. Marek Cieśla 1, B D, Ewa Wypasek 1, 2, B D 1, 2, A, E, F. Abstract

ORIGINAL PAPERS. Marek Cieśla 1, B D, Ewa Wypasek 1, 2, B D 1, 2, A, E, F. Abstract ORIGINAL PAPERS Adv Clin Exp Med 2014, 23, 5, 729 733 ISSN 1899 5276 Copyright by Wroclaw Medical University Marek Cieśla 1, B D, Ewa Wypasek 1, 2, B D 1, 2, A, E, F, Anetta Undas IgA Antiphospholipid

More information

Antiphospholipid antibody syndrome an overview

Antiphospholipid antibody syndrome an overview Antiphospholipid antibody syndrome an overview C Sridevi, DNB (Medicine) DNB (Cardiology) MNAMS* P Krishnam Raju, MD DM (Cardiology)* INTRODUCTION Antiphospholipid antibody syndrome (APLAS) was first described

More information

Potpourri of Hematology Oncology. Jasmine Nabi, M.D. Oncology Associates Hall-Perrine Cancer Center at Mercy

Potpourri of Hematology Oncology. Jasmine Nabi, M.D. Oncology Associates Hall-Perrine Cancer Center at Mercy Potpourri of Hematology Oncology Jasmine Nabi, M.D. Oncology Associates Hall-Perrine Cancer Center at Mercy Lifestyle Modifications to Decrease the Risk of Colorectal Cancer Estimates for 2018 American

More information

Updates in Medical Management of Pulmonary Embolism and Deep Vein Thrombosis. By: Justin Youtsey, Elliott Reiff, William Montgomery, Grant Finlan

Updates in Medical Management of Pulmonary Embolism and Deep Vein Thrombosis. By: Justin Youtsey, Elliott Reiff, William Montgomery, Grant Finlan Updates in Medical Management of Pulmonary Embolism and Deep Vein Thrombosis By: Justin Youtsey, Elliott Reiff, William Montgomery, Grant Finlan Objectives Describe the prevalence of PE and DVT as it relates

More information

Sinus and Cerebral Vein Thrombosis

Sinus and Cerebral Vein Thrombosis Sinus and Cerebral Vein Thrombosis A Summary Sinus and cerebral vein clots are uncommon. They can lead to severe headaches, confusion, and stroke-like symptoms. They may lead to bleeding into the surrounding

More information

DOACs in SPECIAL POPULATIONS

DOACs in SPECIAL POPULATIONS DOACs in SPECIAL POPULATIONS Ann K Wittkowsky PharmD, CACP, FASHP, FCCP Clinical Professor University of Washington School of Pharmacy Director, Anticoagulation Services UWMedicine Department of Pharmacy

More information

AMPLIADO SÍNDROME ANTIFOSFOLÍPIDO SÍNDROME DE SJÖGREN María José Cuadrado Lozano Clínica Universidad de Navarra-Madrid

AMPLIADO SÍNDROME ANTIFOSFOLÍPIDO SÍNDROME DE SJÖGREN María José Cuadrado Lozano Clínica Universidad de Navarra-Madrid AMPLIADO SÍNDROME ANTIFOSFOLÍPIDO SÍNDROME DE SJÖGREN María José Cuadrado Lozano Clínica Universidad de Navarra-Madrid PLASMABLAST PROLIFERATION IS ASSOCIATED WITH TLR7 POLYMORPHISMS AND UPREGULATION OF

More information

Mortality in the Catastrophic Antiphospholipid Syndrome

Mortality in the Catastrophic Antiphospholipid Syndrome ARTHRITIS & RHEUMATISM Vol. 54, No. 8, August 2006, pp 2568 2576 DOI 10.1002/art.22018 2006, American College of Rheumatology Mortality in the Catastrophic Antiphospholipid Syndrome Causes of Death and

More information

Systemic Lupus Erythematosus among Jordanians: A Single Rheumatology Unit Experience

Systemic Lupus Erythematosus among Jordanians: A Single Rheumatology Unit Experience Systemic Lupus Erythematosus among Jordanians: A Single Rheumatology Unit Experience Ala M. AlHeresh MD* ABSTRACT Objectives: To study the characteristics of Systemic Lupus Erythematosus in Jordan and

More information

All about Antiphospholipid Syndrome. M.B. Agarwal, MD Prof & Head, Dept of Haematology, Bombay Hospital Institute of Medical Sciences, Mumbai, India

All about Antiphospholipid Syndrome. M.B. Agarwal, MD Prof & Head, Dept of Haematology, Bombay Hospital Institute of Medical Sciences, Mumbai, India All about Antiphospholipid Syndrome M.B. Agarwal, MD Prof & Head, Dept of Haematology, Bombay Hospital Institute of Medical Sciences, Mumbai, India 1 2 3 4 5 6 Antiphospholipid syndrome A study of 192

More information

VTE in Children: Practical Issues

VTE in Children: Practical Issues VTE in Children: Practical Issues Wasil Jastaniah MBBS,FAAP,FRCPC Consultant Pediatric Hem/Onc/BMT May 2012 Top 10 Reasons Why Pediatric VTE is Different 1. Social, ethical, and legal implications. 2.

More information

Lupus as a risk factor for cardiovascular disease

Lupus as a risk factor for cardiovascular disease Lupus as a risk factor for cardiovascular disease SØREN JACOBSEN Department Rheumatology, Rigshospitalet Søren Jacobsen Main sponsors: Gigtforeningen Novo Nordisk Fonden Rigshospitalet Disclaimer: Novo

More information

THROMBOPHILIA SCREENING

THROMBOPHILIA SCREENING THROMBOPHILIA SCREENING Introduction The regulation of haemostasis Normally, when a clot occurs, it exactly occurs where it has to be and does not grow more than necessary due to the action of the haemostasis

More information

9/25/2013 SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)

9/25/2013 SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) 1 Other Types of Lupus Discoid Lupus Erythematosus Lupus Pernio --- Sarcoidosis Lupus Vulgaris --- Tuberculosis of the face Manifestations of SLE Fever Rashes Arthritis

More information

Sang Hyuk Park, 1,2 Seongsoo Jang, 3 Chan-Jeoung Park, 3 and Hyun-Sook Chi Introduction

Sang Hyuk Park, 1,2 Seongsoo Jang, 3 Chan-Jeoung Park, 3 and Hyun-Sook Chi Introduction BioMed Research International Volume 2016, Article ID 2641526, 6 pages http://dx.doi.org/10.1155/2016/2641526 Research Article Clinical Application of Revised Laboratory Classification Criteria for Antiphospholipid

More information

Haematological abnormalities in systemic lupus erythematosus

Haematological abnormalities in systemic lupus erythematosus ARTigO ORiginAL Haematological abnormalities in systemic lupus erythematosus Aamer Aleem 1, Abdurahman Saud Al Arfaj 2, Najma khalil 2, Husain Alarfaj 2 ACTA REUMATOL PORT. 2014;39:236-241 AbstrAct Objectives:

More information

Mohammadreza Tabatabaei IBTO COAG LAB

Mohammadreza Tabatabaei IBTO COAG LAB Tests for the Evaluation of Lupus Anticoagulants t Mohammadreza Tabatabaei MSc Hematology blood bank MSc Hematology blood bank IBTO COAG LAB Lupus Anticoagulants General Background Lupus anticoagulants

More information

Available Online at CODEN: IJRSFP (USA) Vol. 9, Issue, 3(L), pp , March, 2018.

Available Online at  CODEN: IJRSFP (USA) Vol. 9, Issue, 3(L), pp , March, 2018. ISSN: 0976-3031 Available Online at http://www.recentscientific.com CODEN: IJRSFP (USA) International Journal of Recent Scientific Research Vol. 9, Issue, 3(L), pp. 25504-25508, March, 2018 Research Article

More information

Disclosures. Sneddon Syndrome: Untangling the Web. Case Presentation. MRI head w/ and w/o contrast. Further Workup. Further Workup 10/26/2017

Disclosures. Sneddon Syndrome: Untangling the Web. Case Presentation. MRI head w/ and w/o contrast. Further Workup. Further Workup 10/26/2017 Sneddon Syndrome: Untangling the Web Sadhana Murali, MD, PGY-4 University of Wisconsin-Madison WNS Conference October 27-28, 2017 Disclosures I have no relevant financial relationships with any commercial

More information

Thrombosis and emboli. Peter Nagy

Thrombosis and emboli. Peter Nagy Thrombosis and emboli Peter Nagy A thrombus is any solid object developing from the blood in vivo within the vascular system or heart. Thrombosis is hemostasis in the wrong place. Major components, forms:

More information

THROMBOPHILIA TESTING: PROS AND CONS SHANNON CARPENTER, MD MS CHILDREN S MERCY HOSPITAL KANSAS CITY, MO

THROMBOPHILIA TESTING: PROS AND CONS SHANNON CARPENTER, MD MS CHILDREN S MERCY HOSPITAL KANSAS CITY, MO THROMBOPHILIA TESTING: PROS AND CONS SHANNON CARPENTER, MD MS CHILDREN S MERCY HOSPITAL KANSAS CITY, MO DISCLAIMER I m a pediatrician I will be discussing this issue primarily from a pediatric perspective

More information

We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors

We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 4,000 116,000 120M Open access books available International authors and editors Downloads Our

More information

VENOUS THROMBOEMBOLISM: DURATION OF TREATMENT

VENOUS THROMBOEMBOLISM: DURATION OF TREATMENT VENOUS THROMBOEMBOLISM: DURATION OF TREATMENT OBJECTIVE: To provide guidance on the recommended duration of anticoagulant therapy for venous thromboembolism (VTE). BACKGROUND: Recurrent episodes of VTE

More information

Mabel Labrada, MD Miami VA Medical Center

Mabel Labrada, MD Miami VA Medical Center Mabel Labrada, MD Miami VA Medical Center *1-Treatment for acute DVT with underlying malignancy is for 3 months. *2-Treatment of provoked acute proximal DVT can be stopped after 3months of treatment and

More information

TECHNICAL SERIES. Lupus Anticoagulants: Basic Concepts and Laboratory Diagnosiss. ...Setting trends TULIP DIAGNOSTICS (P) LTD.

TECHNICAL SERIES. Lupus Anticoagulants: Basic Concepts and Laboratory Diagnosiss. ...Setting trends TULIP DIAGNOSTICS (P) LTD. For the use of Registered Medical Practioners and Laboratories only TECHNICAL SERIES Lupus Anticoagulants: Basic Concepts and Laboratory Diagnosiss TULIP DIAGNOSTICS (P) LTD. Gitanjali, Tulip Block, Dr.

More information

Clinical features of Antiphospholipid syndrome (APS) Panayiotis G. Vlachoyiannopoulos MD Medical School National University of Athens 2005

Clinical features of Antiphospholipid syndrome (APS) Panayiotis G. Vlachoyiannopoulos MD Medical School National University of Athens 2005 Clinical features of Antiphospholipid syndrome (APS) Panayiotis G. Vlachoyiannopoulos MD Medical School National University of Athens 2005 Antiphospholipid Syndrome: Definition Recurrent arterial and/or

More information

Duration of Anticoagulant Therapy. Linda R. Kelly PharmD, PhC, CACP September 17, 2016

Duration of Anticoagulant Therapy. Linda R. Kelly PharmD, PhC, CACP September 17, 2016 Duration of Anticoagulant Therapy Linda R. Kelly PharmD, PhC, CACP September 17, 2016 Conflicts of Interest No conflicts of interest to report Objectives At the end of the program participants will be

More information

Close Association between valvular heart disease and central nervous system manifestations in the antiphospholipid syndrome

Close Association between valvular heart disease and central nervous system manifestations in the antiphospholipid syndrome ARD Online First, published on March 18, 2005 as 10.1136/ard.2004.032813 1 Close Association between valvular heart disease and central nervous system manifestations in the antiphospholipid syndrome Category:

More information

Catastrophic antiphospholipid syndrome: A rare but serious complication of antiphospholipid antibody syndrome Sandhu VK*; Singh H

Catastrophic antiphospholipid syndrome: A rare but serious complication of antiphospholipid antibody syndrome Sandhu VK*; Singh H Open Journal of Clinical & Medical Case Reports Volume 3 (2017) Issue 4 ISSN 2379-1039 Catastrophic antiphospholipid syndrome: A rare but serious complication of antiphospholipid antibody syndrome Sandhu

More information

SLE and the Antiphospholipid Syndrome

SLE and the Antiphospholipid Syndrome SLE and the Antiphospholipid Syndrome Susan Y. Ritter MD, PhD Associate Physician Division of Rheumatology, Immunology and Allergy Department of Medicine Brigham and Women s Hospital Instructor in Medicine

More information

Updates in Diagnosis & Management of VTE

Updates in Diagnosis & Management of VTE Updates in Diagnosis & Management of VTE TRACY MINICHIELLO, MD CHIEF, ANTICOAGULATION& THROMBOSIS SERVICE-SAN FRANCISCO VAMC PROFESSOR OF MEDICINE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO Financial Disclosures-NONE

More information

Rituximab. B Cell Inhibition in APS. Methods. B Cell Inhibition in APS. Disclosure 11/6/2011

Rituximab. B Cell Inhibition in APS. Methods. B Cell Inhibition in APS. Disclosure 11/6/2011 Rituximab in Antiphospholipid Syndrome (RITAPS) A Pilot Open-Label Phase II Prospective Trial for Non-Criteria Manifestations of Antiphospholipid Antibodies (NCT: 00537290) Disclosure Research Support:

More information

Antiphospholipid Syndrome Handbook

Antiphospholipid Syndrome Handbook Antiphospholipid Syndrome Handbook Maria Laura Bertolaccini, Oier Ateka-Barrutia, and Munther A. Khamashta Antiphospholipid Syndrome Handbook Maria Laura Bertolaccini, MD, PhD Lupus Research Unit The Rayne

More information

ANTIPHOSPHOLIPID ANTIBODIES IN 57 CHILDREN AND ADOLESCENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

ANTIPHOSPHOLIPID ANTIBODIES IN 57 CHILDREN AND ADOLESCENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS REV. HOSP. CLÍN. FAC. MED. S. PAULO 58(3):157-162, 2003 ANTIPHOSPHOLIPID ANTIBODIES IN 57 CHILDREN AND ADOLESCENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS Lúcia Maria de Arruda Campos, Maria Helena B. Kiss,

More information

Μακροχρόνια παρακολούθηση ασθενών με πνευμονική εμβολή

Μακροχρόνια παρακολούθηση ασθενών με πνευμονική εμβολή Μακροχρόνια παρακολούθηση ασθενών με πνευμονική εμβολή Ευφροσύνη Δ. Μάναλη Λέκτορας Β Πανεπιστημιακή Πνευμονολογική Κλινική ΓΝΑ «Αττικόν» Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών Existing guidelines

More information

A Case of Massive Pulmonary Embolism in Systemic Lupus Erythematosus without Antiphospholipid Antibody

A Case of Massive Pulmonary Embolism in Systemic Lupus Erythematosus without Antiphospholipid Antibody Journal of Rheumatic Diseases Vol. 22, No. 2, April, 2015 http://dx.doi.org/10.4078/jrd.2015.22.2.106 Case Report A Case of Massive Pulmonary Embolism in Systemic Lupus Erythematosus without Antiphospholipid

More information

Conflict of Interest. Systemic Lupus Erythematosus and the Antiphospholipid Syndrome Bonnie L. Bermas, MD Brigham and Women s Hospital.

Conflict of Interest. Systemic Lupus Erythematosus and the Antiphospholipid Syndrome Bonnie L. Bermas, MD Brigham and Women s Hospital. Systemic Lupus Erythematosus and the Antiphospholipid Syndrome Bonnie L. Bermas, MD Brigham and Women s Hospital Conflict of Interest Disclosures: None Overview Diagnostic Classification Criteria of SLE

More information

Središnja medicinska knjižnica

Središnja medicinska knjižnica Središnja medicinska knjižnica Jelušić M., Starčević K., Vidović M., Dobrota S., Potočki K., Banfić Lj., Anić B. (2013) Familial antiphospholipid syndrome presenting as bivessel arterial occlusion in a

More information

DVT and Pulmonary Embolus. Dr Piers Blombery BSc(Biomed), MBBS (Hons), FRACP, FRCPA Consultant Haematologist Peter MacCallum Cancer Centre

DVT and Pulmonary Embolus. Dr Piers Blombery BSc(Biomed), MBBS (Hons), FRACP, FRCPA Consultant Haematologist Peter MacCallum Cancer Centre DVT and Pulmonary Embolus Dr Piers Blombery BSc(Biomed), MBBS (Hons), FRACP, FRCPA Consultant Haematologist Peter MacCallum Cancer Centre Overview Structure of deep and superficial venous system of upper

More information

Testing strategies for diagnosing lupus anticoagulant: decision analysis Segal J B, Lehmann H P, Petri M, Mueller L, Kickler T S

Testing strategies for diagnosing lupus anticoagulant: decision analysis Segal J B, Lehmann H P, Petri M, Mueller L, Kickler T S Testing strategies for diagnosing lupus anticoagulant: decision analysis Segal J B, Lehmann H P, Petri M, Mueller L, Kickler T S Record Status This is a critical abstract of an economic evaluation that

More information

THROMBOSIS RISK FACTOR ASSESSMENT

THROMBOSIS RISK FACTOR ASSESSMENT Name: Procedure: Doctor: Date: THROMBOSIS RISK FACTOR ASSESSMENT CHOOSE ALL THAT APPLY EACH RISK FACTOR REPRESENTS 1 POINT Age 41 60 years Minor Surgery Planned History of Prior Major Surgery (< 1 month)

More information

Case Report Catastrophic Antiphospholipid Syndrome Presenting as Bilateral Central Retinal Artery Occlusions

Case Report Catastrophic Antiphospholipid Syndrome Presenting as Bilateral Central Retinal Artery Occlusions Hindawi Publishing Corporation Case Reports in Ophthalmological Medicine Volume 2015, Article ID 206906, 5 pages http://dx.doi.org/10.1155/2015/206906 Case Report Catastrophic Antiphospholipid Syndrome

More information

Central nervous system involvement in the antiphospholipid (Hughes) syndrome

Central nervous system involvement in the antiphospholipid (Hughes) syndrome Rheumatology 2003;42:200 213 doi:10.1093/rheumatology/keg080, available online at www.rheumatology.oupjournals.org Review Central nervous system involvement in the antiphospholipid (Hughes) syndrome G.

More information

APPENDIX 2 Eight New Cases of LAHS and Review of Literature: Treatment and Follow-Up

APPENDIX 2 Eight New Cases of LAHS and Review of Literature: Treatment and Follow-Up Supplementary Digital Content 2 Mazodier Lupus Anticoagulant- Hypoprothrombinemia Syndrome: Report of 8 Cases and Review of the Literature Medicine (Baltimore). 2012;91(5). APPEIX 2 Eight New Cases of

More information

Patent Foramen Ovale and Cryptogenic Stroke: Do We Finally Have Closure? Christopher Streib, MD, MS

Patent Foramen Ovale and Cryptogenic Stroke: Do We Finally Have Closure? Christopher Streib, MD, MS Patent Foramen Ovale and Cryptogenic Stroke: Do We Finally Have Closure? Christopher Streib, MD, MS 11-8-18 Outline 1. Background 2. Anatomy of patent foramen ovale (PFO) 3. Relationship between PFO and

More information

Clinical consequences of antiphospholipid antibodies

Clinical consequences of antiphospholipid antibodies Clinical consequences of antiphospholipid antibodies R.H.W.M. Derksen 1*, P.G. de Groot 2,3 1 Department of Rheumatology and Clinical Immunology, Room F02.127, 2 Thrombosis and Haemostasis Laboratory,

More information

THROMBOSIS PRODUCT HIGHLIGHTS

THROMBOSIS PRODUCT HIGHLIGHTS PRODUCT HIGHLIGHTS AESKU.DIAGNOSTICS has extensive experience and know-how in the Anti-Phospholipid Syndrome (APS) field and offers the most comprehensive panel of anti-phospholipid tests, employing highly

More information

Development of SLE among Possible SLE Patients Seen in Consultation: Long-Term Follow-Up. Disclosures. Background. Evidence-Based Medicine.

Development of SLE among Possible SLE Patients Seen in Consultation: Long-Term Follow-Up. Disclosures. Background. Evidence-Based Medicine. Development of SLE among Patients Seen in Consultation: Long-Term Follow-Up Abstract # 1699 May Al Daabil, MD Bonnie L. Bermas, MD Alexander Fine Hsun Tsao Patricia Ho Joseph F. Merola, MD Peter H. Schur,

More information

Objective Teaching Methods Assessment

Objective Teaching Methods Assessment Rotation: Vascular Medicine Director: Mark Robbins, M.D. Learning Objectives Patient Care Obtain and document complete medical histories, including review of patient medical records, and perform accurate

More information

Guidelines. 704 q 2000 Blackwell Science Ltd GUIDELINES ON THE INVESTIGATION AND MANAGEMENT OF THE ANTIPHOSPHOLIPID SYNDROME

Guidelines. 704 q 2000 Blackwell Science Ltd GUIDELINES ON THE INVESTIGATION AND MANAGEMENT OF THE ANTIPHOSPHOLIPID SYNDROME British Journal of Haematology 2000, 109, 704±715 Guidelines GUIDELINES ON THE INVESTIGATION AND MANAGEMENT OF THE ANTIPHOSPHOLIPID SYNDROME In 1991, the Haemostasis and Thrombosis Task Force of the British

More information

World Journal of Pharmaceutical Research

World Journal of Pharmaceutical Research World Journal of Pharmaceutical research Al-Aubaidy et al. Volume 3, Issue 2, XXX-XXX. Research Article ISSN 2277 7105 RESPONSE OF ANTI-CARDIOLIPIN ANTIBODIES TO VARIOUS TREATMENT MODALITIES IN GUILLAIN

More information

What is the real place of venous echo Doppler in aircrew member flying rehabilitation after a thromboembolism event?

What is the real place of venous echo Doppler in aircrew member flying rehabilitation after a thromboembolism event? 89 th ASMA ANNUAL SCIENTIFIC MEETING DALLAS- May 6-10, 2018 What is the real place of venous echo Doppler in aircrew member flying rehabilitation after a thromboembolism event? S BISCONTE (1), V MARICOURT

More information

Approach to Thrombosis

Approach to Thrombosis Approach to Thrombosis Theera Ruchutrakool, M.D. Division of Hematology Department of Medicine Siriraj Hospital Faculty of Medicine Mahidol University Approach to Thrombosis Thrombosis: thrombus formation

More information

Supplemental Digital Content: Definitions Based on the International Classification of Diseases, Ninth Revision, Clinical Modification

Supplemental Digital Content: Definitions Based on the International Classification of Diseases, Ninth Revision, Clinical Modification Supplemental Digital Content: Definitions Based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Diagnose and Procedures Codes 1. ICD-9-CM definition of

More information

Comorbidity or medical history Existing diagnoses between 1 January 2007 and 31 December 2011 AF management care AF symptoms Tachycardia

Comorbidity or medical history Existing diagnoses between 1 January 2007 and 31 December 2011 AF management care AF symptoms Tachycardia Supplementary Table S1 International Classification of Disease 10 (ICD-10) codes Comorbidity or medical history Existing diagnoses between 1 January 2007 and 31 December 2011 AF management care I48 AF

More information

Venous thrombosis is common and often occurs spontaneously, but it also frequently accompanies medical and surgical conditions, both in the community

Venous thrombosis is common and often occurs spontaneously, but it also frequently accompanies medical and surgical conditions, both in the community Venous Thrombosis Venous Thrombosis It occurs mainly in the deep veins of the leg (deep vein thrombosis, DVT), from which parts of the clot frequently embolize to the lungs (pulmonary embolism, PE). Fewer

More information

Central Nervous System (CNS) and Lupus: Learn from the Experts. Betty Diamond, M.D. Feinstein Institute for Medical Research

Central Nervous System (CNS) and Lupus: Learn from the Experts. Betty Diamond, M.D. Feinstein Institute for Medical Research Central Nervous System (CNS) and Lupus: Learn from the Experts Betty Diamond, M.D. Feinstein Institute for Medical Research Stages in SLE Pathogenesis Crow MK, Arth Res & Tx. 2009 ACR Criteria for the

More information

Case Report Antiphospholipid Syndrome: Multiple Manifestations in a Single Patient A High Suspicion Is Still Needed

Case Report Antiphospholipid Syndrome: Multiple Manifestations in a Single Patient A High Suspicion Is Still Needed Hindawi Case Reports in Medicine Volume 2017, Article ID 5797041, 4 pages https://doi.org/10.1155/2017/5797041 Case Report Antiphospholipid Syndrome: Multiple Manifestations in a Single Patient A High

More information

DVT PROPHYLAXIS IN HOSPITALIZED MEDICAL PATIENTS SAURABH MAJI SR (PULMONARY,MEDICINE)

DVT PROPHYLAXIS IN HOSPITALIZED MEDICAL PATIENTS SAURABH MAJI SR (PULMONARY,MEDICINE) DVT PROPHYLAXIS IN HOSPITALIZED MEDICAL PATIENTS SAURABH MAJI SR (PULMONARY,MEDICINE) Introduction VTE (DVT/PE) is an important complication in hospitalized patients Hospitalization for acute medical illness

More information

ORIGINAL INVESTIGATION

ORIGINAL INVESTIGATION ORIGINAL INVESTIGATION High Impact of Antiphospholipid Syndrome on Irreversible Organ Damage and Survival of Patients With Systemic Lupus Erythematosus Guillermo Ruiz-Irastorza, MD, PhD; Maria-Victoria

More information

Review Article. Catastrophic Antiphospholipid Syndrome. Introduction. Etiopathogenesis. Man-Chi Leung and Woon-Leung Ng

Review Article. Catastrophic Antiphospholipid Syndrome. Introduction. Etiopathogenesis. Man-Chi Leung and Woon-Leung Ng Review Article Catastrophic Antiphospholipid Syndrome Man-Chi Leung and Woon-Leung Ng Abstract: Keywords: The catastrophic antiphospholipid syndrome is a potentially life threatening rheumatological condition

More information

TN Bundled Payment Initiative: Overview of Episode Risk Adjustment

TN Bundled Payment Initiative: Overview of Episode Risk Adjustment TN Bundled Payment Initiative: Overview of Episode Risk Adjustment United Healthcare, April 2014 The State of Tennessee has implemented an episode-based approach to reimburse providers for the care delivered

More information

ESIM 2014 Clinical Case Presentation Israel. Ben-Sasson Maayan Bnei-Zion medical center Haifa

ESIM 2014 Clinical Case Presentation Israel. Ben-Sasson Maayan Bnei-Zion medical center Haifa ESIM 2014 Clinical Case Presentation Israel Ben-Sasson Maayan Bnei-Zion medical center Haifa Presentation A 24 YO male,a ping-pong player, presented to the ER with acute onset of right upper extremity

More information

10/24/2013. Heparin-Induced Thrombocytopenia (HIT) Anticoagulation Management in ECMO Therapy:

10/24/2013. Heparin-Induced Thrombocytopenia (HIT) Anticoagulation Management in ECMO Therapy: Anticoagulation Management in ECMO Therapy: Heparin-Induced (HIT) Michael H. Creer, MD Professor of Pathology Director, Clinical Laboratories, Medical Co- Director, Hematopathology and Chief, Division

More information

HAEMATOLOGY. Test Name Status Result Unit Reference Interval HbA1c (Glycated Haemoglobin) 5.4 % Method : HPLC Sample Type : Whole Blood EDTA

HAEMATOLOGY. Test Name Status Result Unit Reference Interval HbA1c (Glycated Haemoglobin) 5.4 % Method : HPLC Sample Type : Whole Blood EDTA Institution Report Date 25-Dec-2016 05:59 PM HAEMATOLOGY HbA1c (Glycated Haemoglobin) 5.4 % 4.5-6.0 Method : HPLC Sample Type : Whole Blood EDTA REMARKS In vitro quantitative determination of HbA1c in

More information