Serological evolution in women with positive antiphospholipid antibodies
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Riancho Zarrabeitia, Leyre; Daroca, Germán; Muñoz, Pedro; López Hoyos, Marcos; Haya Torres, Ana Rosa; Martínez Taboada, Víctor ManuelFecha
2017-12Derechos
© 2017, Elsevier. Licensed under the Creative Commons Reconocimiento-NoComercial-SinObraDerivada
Publicado en
Seminars in Arthritis and Rheumatism
Volume 47, Issue 3, December 2017, Pages 397-402
Editorial
Elsevier
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Palabras clave
Antiphospholipid antibodies
Serological evolution
Antiphospholipid síndrome
Resumen/Abstract
Objectives
To explore the clinical and serological course of fertile women with positive antiphospholipid (aPL), and the factors and therapeutic implications associated with aPL negativization.
Methods
Retrospective study including 105 women with a positive aPL serology between 1995 and 2013 attending the obstetric autoimmune pathology clinic of a tertiary facility. Patients were classified into the following 3 groups: patients with primary antiphospholipid syndrome (pAPS, 49), patients with a positive serology for aPL, not meeting clinical criteria (42), and patients with systemic lupus erythematosus and a positive aPL serology (14). They were also classified according to the serological aPL evolution: persistently negative aPL, transiently positive serology, and persistently positive serology according to established criteria.
Results
After a mean follow-up of 114.4 ± 37.2 months, 59% of patients had persistently negative antibodies, while 25.7% of patients presented persistently positive aPL serology. Multivariate analysis confirmed that smoking (OR = 4; 95% CI: 1.45?11.08; p = 0.008) was an independent risk factor for positive persistence. Persistent positivity as well as a higher antibody load was associated with higher risk for further pregnancy morbidity. In 29 patients, with persistently negative serology who were asymptomatic, treatment with low-dose aspirin was discontinued. No clinical events related to APS were reported after treatment withdrawal, during the 40.95 months of follow-up.
Conclusions
A significant proportion of fertile women with aPL antibodies became negative during follow-up. Tobacco use and the number of positive antibodies are associated with persistently positive serology. Patients with persistently positive aPL serology suffer more obstetric complications. Treatment withdrawal might be safe in selected patients.
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