Cargando…

An advanced understanding of the heterogeneous clinical features of “non-criteria” obstetric antiphospholipid syndrome: Two case reports and a literature review

Antiphospholipid syndrome (APS) is an acquired autoimmune disorder characterized by recurrent venous and/or arterial thrombosis and/or pregnancy complications, in the presence of elevated antiphospholipid (aPL) antibodies. APS in pregnant women is referred to as “obstetrical” APS (OAPS). The diagnos...

Descripción completa

Detalles Bibliográficos
Autores principales: Peng, Xue, Tan, Xi, Xing, Aiyun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9971720/
https://www.ncbi.nlm.nih.gov/pubmed/36865564
http://dx.doi.org/10.3389/fimmu.2023.1122127
_version_ 1784898158486093824
author Peng, Xue
Tan, Xi
Xing, Aiyun
author_facet Peng, Xue
Tan, Xi
Xing, Aiyun
author_sort Peng, Xue
collection PubMed
description Antiphospholipid syndrome (APS) is an acquired autoimmune disorder characterized by recurrent venous and/or arterial thrombosis and/or pregnancy complications, in the presence of elevated antiphospholipid (aPL) antibodies. APS in pregnant women is referred to as “obstetrical” APS (OAPS). The diagnosis of definite OAPS requires the presence of one or more typical clinical criteria and persistent aPL antibodies at least 12 weeks apart. However, the classification criteria for OAPS have generated wide discussion, with a growing impression that certain patients not fully meeting these criteria might be inappropriately excluded from the classification, which is known as “non-criteria” OAPS. We present here two unique cases of potentially lethal “non-criteria” OAPS, complicating severe preeclampsia, fetal growth restriction (FGR), liver rupture, preterm birth, refractory recurrent miscarriages, or even stillbirth. We further share our diagnostic search and analysis, treatment adjustment, and prognosis for this unusual antenatal event. We will also present a short review of an advanced understanding of the pathogenetic mechanisms of this disease, heterogeneous clinical features, and potential significance.
format Online
Article
Text
id pubmed-9971720
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-99717202023-03-01 An advanced understanding of the heterogeneous clinical features of “non-criteria” obstetric antiphospholipid syndrome: Two case reports and a literature review Peng, Xue Tan, Xi Xing, Aiyun Front Immunol Immunology Antiphospholipid syndrome (APS) is an acquired autoimmune disorder characterized by recurrent venous and/or arterial thrombosis and/or pregnancy complications, in the presence of elevated antiphospholipid (aPL) antibodies. APS in pregnant women is referred to as “obstetrical” APS (OAPS). The diagnosis of definite OAPS requires the presence of one or more typical clinical criteria and persistent aPL antibodies at least 12 weeks apart. However, the classification criteria for OAPS have generated wide discussion, with a growing impression that certain patients not fully meeting these criteria might be inappropriately excluded from the classification, which is known as “non-criteria” OAPS. We present here two unique cases of potentially lethal “non-criteria” OAPS, complicating severe preeclampsia, fetal growth restriction (FGR), liver rupture, preterm birth, refractory recurrent miscarriages, or even stillbirth. We further share our diagnostic search and analysis, treatment adjustment, and prognosis for this unusual antenatal event. We will also present a short review of an advanced understanding of the pathogenetic mechanisms of this disease, heterogeneous clinical features, and potential significance. Frontiers Media S.A. 2023-02-14 /pmc/articles/PMC9971720/ /pubmed/36865564 http://dx.doi.org/10.3389/fimmu.2023.1122127 Text en Copyright © 2023 Peng, Tan and Xing https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Peng, Xue
Tan, Xi
Xing, Aiyun
An advanced understanding of the heterogeneous clinical features of “non-criteria” obstetric antiphospholipid syndrome: Two case reports and a literature review
title An advanced understanding of the heterogeneous clinical features of “non-criteria” obstetric antiphospholipid syndrome: Two case reports and a literature review
title_full An advanced understanding of the heterogeneous clinical features of “non-criteria” obstetric antiphospholipid syndrome: Two case reports and a literature review
title_fullStr An advanced understanding of the heterogeneous clinical features of “non-criteria” obstetric antiphospholipid syndrome: Two case reports and a literature review
title_full_unstemmed An advanced understanding of the heterogeneous clinical features of “non-criteria” obstetric antiphospholipid syndrome: Two case reports and a literature review
title_short An advanced understanding of the heterogeneous clinical features of “non-criteria” obstetric antiphospholipid syndrome: Two case reports and a literature review
title_sort advanced understanding of the heterogeneous clinical features of “non-criteria” obstetric antiphospholipid syndrome: two case reports and a literature review
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9971720/
https://www.ncbi.nlm.nih.gov/pubmed/36865564
http://dx.doi.org/10.3389/fimmu.2023.1122127
work_keys_str_mv AT pengxue anadvancedunderstandingoftheheterogeneousclinicalfeaturesofnoncriteriaobstetricantiphospholipidsyndrometwocasereportsandaliteraturereview
AT tanxi anadvancedunderstandingoftheheterogeneousclinicalfeaturesofnoncriteriaobstetricantiphospholipidsyndrometwocasereportsandaliteraturereview
AT xingaiyun anadvancedunderstandingoftheheterogeneousclinicalfeaturesofnoncriteriaobstetricantiphospholipidsyndrometwocasereportsandaliteraturereview
AT pengxue advancedunderstandingoftheheterogeneousclinicalfeaturesofnoncriteriaobstetricantiphospholipidsyndrometwocasereportsandaliteraturereview
AT tanxi advancedunderstandingoftheheterogeneousclinicalfeaturesofnoncriteriaobstetricantiphospholipidsyndrometwocasereportsandaliteraturereview
AT xingaiyun advancedunderstandingoftheheterogeneousclinicalfeaturesofnoncriteriaobstetricantiphospholipidsyndrometwocasereportsandaliteraturereview