The Antiphospholipid Syndrome: 62 Cases
Main Author: Zohra Aydi
Tunis, Tunisia
Habib Thameur Hospital
Introduction:
The antiphospholipid syndrome is an autoimmune and thrombogenic pathology that the diagnosis is based on clinical and biological criteria. The SAPL can be isolated (primary SAPL) or associated with another auto-immune disease (secondary SAPL), most of the time a systemic lupus erythematosus. The purpose of this work is to finalize the epidemiological, clinical, biological, characteristic and the therapeutic and evolutionary modalities of the SAPL in these various forms.The antiphospholipid syndrome is an autoimmune and thrombogenic pathology that the diagnosis is based on clinical and biological criteria. The SAPL can be isolated (primary SAPL) or associated with another auto-immune disease (secondary SAPL), most of the time a systemic lupus erythematosus. The purpose of this work is to finalize the epidemiological, clinical, biological, characteristic and the therapeutic and evolutionary modalities of the SAPL in these various forms.
Method(s):
We led a retrospective and descriptive study of the patients followed in the service of internal medicine of the hospital Habib Thameur of Tunis for SAPL
Results:
We brought together 62 cases distributed in 61 women and 1 man. The average age was 41 years.The peripheral thromboses were observed in 51.6 %. The obstetric accidents were found at 26 patients dominated by repeated abortion (35.5 %) and fetal death in uterus (16.1 %). The cardiac infringement was dominated by valvular disease in 9.6 %. The lung demonstrations were represented by a pulmonary embolism in 32.25 % and a lung arterial high blood pressure in 19.3 %. The neurological infringement was present in 29 % (Cerebrovascular accident in 52.6%, cerebral venous thrombosis in 3.2%). The SAPL was primary in 32 % and secondary in 86%. The CAPS was found in 2 cases. The systemic lupus erythematosus was present in 59.7%. The immunological balance sheet revealed aCL in 77.4 %, anti-ß 2GPI in 24.2 % and anti-PT in 17.7 %. The comparative study showed a statistically significant correlation between the obstetric and vascular sign with the presence of aCL. A corticosteroid therapy (1 mg/kg/j) was indicated in 61.3 % and immunosuppressive in 43.5 %.
Conclusion:
The antiphospholipid syndrome is a complex entity among which the knowledge and the understanding are in permanent evolution. It is necessary to think of it in front of any vascular reccurent thrombosis to a young subject or of unusual seat and in front of obstetric recurent accidents.
