Primary and secondary antiphospholipid syndrome characteristics in an Egyptian cohort

Abstract

Aim of the workTo describe the clinical and laboratory characteristics of patients with primary and secondary antiphospholipid syndrome (APS) in an Egyptian cohort. Patients and methodsSixty APS patients were enrolled. 12 had primary APS and 48 had secondary. Patients were further classified according to the presence of double or triple antiphospholipid antibodies (aPL). ResultsThe study included 55 (91.7 %) females and 5 (8.3 %) males, with a mean age of 33.9 ± 9.1 years, and mean disease duration of 6.2 ± 93.04 years. The obstetric complication in the form of fetal loss was the commonest manifestation of APS (70 %), followed by lower limb deep venous thrombosis (DVT) (50 %), recurrent abortion (45 %), thrombocytopenia (25 %), cutaneous manifestations (20 %), and Raynaud’s phenomenon (18.3 %). Urinary findings are mostly related to secondary APS. 15 (25 %) patients were thrombocytopenic and 1 (1.7 %) had autoimmune hemolytic anemia. Primary APS patients showed higher frequency of cutaneous manifestations compared to secondary (50 % vs 12.5 %; p = 0.04), and higher levels of β2 glycoprotein I IgG (71.8 ± 22.4 U/ml vs 59.3 ± 17.1 U/ml; p = 0.047). Secondary APS patients showed positive antinuclear antibodies (ANA) and anti-double stranded deoxyribonucleic acid antibodies (anti-dsDNA) in 97.9 % and 93.8 % respectively and were negative in all primary APS patients. On comparing patients with double (n = 34) and triple (n = 26) aPL, no differences were found between both groups except for platelet count being significantly lower in the triple aPL (p = 0.045). ConclusionEgyptian APS patients showed a high frequency of obstetric complications and lower limb DVT. Primary APS patients had higher frequency of cutaneous manifestations.