PS1585 ELDERLY WITH ANTIPHOSPHOLIPID SYNDROME PRESENT WITH DISTINCT CLINICAL PROFILE: A RETROSPECTIVE SINGLE CENTER STUDY

Abstract

Background:Antiphospholipid syndrome (APS) is an acquired autoimmune disorder. It is characterized by venous and/or arterial thrombosis and/or pregnancy related morbidity in the presence of persistent antiphospholipid antibodies (aPL). It can occur as primary or as secondary APS in association with an autoimmune disorder (usually SLE). APS mainly affects women who are of child‐bearing age and less often elderly patients.Aims:We aimed to describe the clinical and immunological features of APS in patients diagnosed after the age of 55.Methods:The PSA (Phospholipid Syndrome Aged) study is a retrospective study of patients with suspected APS, who were referred to the Thrombosis and Haemostasis Clinic during the last decade (2009–2018). Clinical and serological data of patients with late onset APS (occurred after the age of 55) were analyzed and compared with patients presenting with early onset APS. The aPL (anticardiolipin (ACA) and anti‐b2GP‐I antibodies, IgG and IgM) were measured by ELISA (Euroimmun, Germany).Results:We evaluated 149 patients diagnosed with APS (56,4% males, median age 43,74 ± 13,4 years). Patients with late onset APS were 32 (21,5%) and consisted Group A. The other 117 patients were Group B. Median follow‐up was 62,5 months (13–147). The most common clinical manifestation was stroke (20,5%), followed by deep vein thrombosis of the lower extremities (15,4%) and pulmonary embolism (12,7%). Clinical characteristics of patients are shown in table 1. x2 test was used to assess statistical significance.All triple positive patients were in group B (10 women and one man). All patients were treated with antithrombotic treatment including antiplatelet agents (26,5%) and/or oral anticoagulants (69%). 14% of the patients received only LMWH (younger women). Male gender, LA positivity and a higher frequency of secondary APS were statistically significant in the older group.Summary/Conclusion:Elderly APS patients should not be disregarded because they represent 21,4% of an APS population. Patients aged >55 who are diagnosed with APS share a distinct disease profile. Clinicians must be aware of this situation in order to identify specific causes, to evaluate the risk of recurrence and to establish a therapeutic approach.image