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Aneurysms in primary antiphospholipid syndrome: a case-based review
Jozélio Freire de Carvalho1, Yehuda Shoenfeld2,3
1Institute for Health Sciences from Federal University of Bahia, Rua das Violetas, 42, ap. 502, Pituba, Salvador, Bahia, Brazil. jotafc@gmail.com.
Clinical Rheumatology
|January 4, 2021
Summary
Primary antiphospholipid syndrome (APS) can lead to aneurysms, particularly in women with a history of recurrent abortions and deep venous thromboses, often associated with lupus anticoagulant. Early detection and management are crucial for patients with APS and aneurysm.
Area of Science:
- Rheumatology
- Vascular Medicine
- Immunology
Background:
- Primary antiphospholipid syndrome (APS) is an autoimmune disorder associated with an increased risk of thrombosis and pregnancy complications.
- Aneurysms, abnormal dilations of blood vessels, can occur in various arterial locations and pose significant health risks.
- The association between APS and aneurysm formation is not well-established, necessitating further investigation.
Purpose of the Study:
- To review and synthesize existing literature on patients diagnosed with primary antiphospholipid syndrome (APS) who subsequently developed aneurysms.
- To identify common clinical characteristics, affected vessels, antiphospholipid antibody profiles, and outcomes in APS patients with aneurysms.
Main Methods:
- A comprehensive literature review was conducted using PubMed/MEDLINE, LILACS, and SciELO databases.
- Search terms included 'Antiphospholipid syndrome' and 'aneurysm', with no language restrictions, covering publications from 1966 to October 2020.
- Data from 10 articles and one additional case were analyzed, totaling 14 patients.
Main Results:
- The study reviewed 14 cases of APS patients with aneurysms, predominantly affecting females (54%) aged 20-76 years.
- Commonly affected arterial vessels included the aorta, coronary, hepatic, renal, and middle cerebral arteries.
- Frequent antiphospholipid antibodies were lupus anticoagulant, anti-beta2-glycoprotein I, and anticardiolipin antibodies. Associated APS manifestations included deep venous thrombosis and recurrent abortions.
Conclusions:
- Women with a history of recurrent abortions and deep venous thromboses, particularly those with lupus anticoagulant, represent a high-risk group for aneurysm development in APS.
- This review highlights the importance of considering aneurysm as a potential complication in APS patients, especially those with specific clinical and serological profiles.
- Further research is warranted to elucidate the precise mechanisms linking APS and aneurysm formation and to optimize management strategies.
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