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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
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Antiphospholipid syndrome: A diagnostic challenge.

R S Mallhi1, Neerja Kushwaha2, T Chatterjee3

  • 1Professor, Department of Immunohaematology & Blood Transfusion, Armed Forces Medical College, Pune 411040, India.

Medical Journal, Armed Forces India
|January 5, 2017
PubMed
Summary

Antiphospholipid syndrome (APS) involves blood clots and pregnancy issues due to antibodies targeting proteins, not phospholipids. Accurate diagnosis of this autoimmune disorder remains challenging despite established criteria.

Keywords:
Antiphospholipid antibodiesLupus anticoagulantRecurrent pregnancy lossVenous and arterial thrombosis

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Area of Science:

  • Autoimmune disorders
  • Thrombophilia
  • Clinical immunology

Background:

  • Antiphospholipid syndrome (APS) is an acquired autoimmune disorder characterized by thrombosis and obstetric complications.
  • It involves antibodies targeting plasma proteins bound to anionic phospholipids, not phospholipids themselves.
  • The etiology of APS is multifactorial and not fully understood.

Approach:

  • Diagnostic criteria for APS have evolved, with revisions in 1999 (Sapporo) and 2006 (Sydney Consensus).
  • Key changes include incorporating β2 glycoprotein I (β2GPI) as a laboratory criterion and specific clinical manifestations like ischemic stroke.
  • Recommended laboratory tests include coagulation assays for lupus anticoagulant and ELISAs for antibodies against cardiolipin and β2GPI.

Key Points:

  • APS diagnosis requires at least one clinical and one laboratory criterion.
  • Current diagnostic tests face limitations in standardization, reproducibility, and robustness.
  • Accurate diagnosis is challenging, necessitating close collaboration between clinicians and laboratory professionals.

Conclusions:

  • Despite established guidelines, diagnosing APS remains a significant clinical challenge.
  • Misdiagnosis of APS can lead to severe patient outcomes.
  • Enhanced interaction between clinical and laboratory settings is crucial for accurate APS diagnosis.