Clinical and Serological Findings of Patients with Antiphospholipid Syndrome in Mashhad, Iran, from 2008 to 2018: A Retrospective, Descriptive, Cross-sectional Study.

Abstract

Antiphospholipid syndrome (APS) is among the autoimmune disorders caused by antiphospholipid antibodies, which provoke blood clots (thrombosis) in arteries and veins. It can also cause such complications as severe preeclampsia, miscarriage, premature birth, and stillbirth in pregnant women. We investigated the clinical and serological characteristics of antiphospholipid syndrome patients. This retrospective cross-sectional study was performed on those with persistently positive antiphospholipid syndrome. Data were extracted from medical records from the hospital information system(HIS) of rheumatology, neurology, cardiology, gynecology, general, and hematology wards of Ghaem Hospital and private rheumatology clinics of Mashhad, which were surveyed for 10 years (2008-2018). Of the 284 patients, 85.6% were female. The most common adverse outcome of pregnancy was miscarriage (68.1%). Non-criteria manifestations, including arthralgia and arthritis, were observed in 37.7% and 33.1% of the patients, respectively. Moreover, deep vein thrombosis (DVT) and cerebrovascular accident (CVA) (13%), organ gangrene (7.4%), and pulmonary thromboendarterectomy (PTE) and transient ischemic attack (TIA) (4.6%) were the most common thrombotic events in antiphospholipid syndrome patients. Deep vein thrombosis was seen in 70.3% of females (P=.005), and subclavian thrombosis was seen in 66.7% of males (P < .001). The risk of DVT in the presence of anti-cardiolipin Ab IgG positive was increased 2.7 times (CI: 95%, 1.2-5.7; P=.007), and it was increased 2.4 times in the presence of anti-β-2 glycoprotein 1 Ab IgG positive (CI: 95%, 1-5.8; P=.033) and 4.2 times in the presence of lupus anticoagulant Ab positive (CI: 95%, 1.9-9.1; P < .001). In patients with anti-β-2 glycoprotein 1 Ab IgG positive, the risk of placental dysfunction increased 4.3 times (CI: 95%, 0.9-20.3; P=.04). This study's results found that this APS syndrome is mainly seen in women with a mean age of 38, and the most common symptoms associated with it are DVT, CVA, and abortion. Anti-β-2 Glycoprotein 1 Ab IgM and Anti-Cardiolipin Ab IgM were the most common positive antibodies in the patients.