Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: The relevance of non-criteria clinical manifestations of antiphospholipid syndrome (APS) has been less studied than its thrombotic and obstetric features. The aim of this study was to evaluate the relationship of APS non-criteria clinical manifestations with antiphospholipid antibodies and damage accrual.
Methods: We retrospectively included 176 patients with APS according to Sydney or Alarcon-Segovia’s criteria. We registered demographics, antiphospholipid antibody profile, use of prednisone and immunosuppresors, thrombotic and obstetric manifestations as well as the following so-called non-criteria clinical manifestations: cutaneous (livedo reticularis, skin ulceration,) hematological (thrombocytopenia, hemolytic anemia), renal (microangiopathy, proteinuria or renal impairment), heart valve disease, and neurological (chorea, migraine, seizures and myelitis). We scored a modified SLICC index where we also included the variables racemous livedo, adrenal insufficiency, placing of Greenfield filter and sclerosis multiple-like disease. We used descriptive statistics and logistic regression and reported OR with 95% CI.
Results: Seventy-eight percent of our patients were women with a mean age of 43.1 ± 14.7 years and median follow-up of 6.7 years. We observed thrombosis in 73%, obstetric features in 20% and 64% had non-criteria clinical manifestations (not exclusive groups). 73 patients (41.4%) had both thrombosis and a non-criteria clinical manifestation (10 concomitant, 42 post-thrombotic and 21 pre-thrombosis).The frequency of the non-criteria clinical manifestation were: hematological 64%, cutaneous 33%, neurological 27%, cardiological 8.2% and renal 6.4%. The univariate analysis showed that the prevalence of LA was higher in the non-criteria clinical manifestation group (53.2% vs. 69.5%, p=0.03). This group also used more prednisone (35.8% vs.1%, <0.0001) and immunosupressors (48.6% vs. 0%, p <0.0001) and had a higher SLICC modified score SLICC (1.69±1.9 vs. 1.1±1.5, p=0.04). Most of the weight of the SLICC score was attributed to the neurologic, pulmonar and peripheral vascular domains. The variables associated with a modified SLICC ≥ 1 were thrombosis (OR 11.5; IC 95% 4.43-30.1; P≤ 0.0001), livedo reticularis (OR 5.45; IC 95% 1.49-19.8; P=0.01) and obstetric features (OR 0.30; IC 95% 0.12-0.7; P=0.01).
Conclusion: The APS non-criteria clinical manifestations are frequent, can precede or follow thrombosis and are associated with LA. Damage accrual was mainly associated with thrombotic events followed by lived reticularis.
To cite this abstract in AMA style:Hernandez-Molina G, Maldonado-Garcia C, Cabral AR. Non-Criteria Clinical Manifestations in Antiphospholipid Syndrome: Clinical Behavior and Association with Damage Accrual [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/non-criteria-clinical-manifestations-in-antiphospholipid-syndrome-clinical-behavior-and-association-with-damage-accrual/. Accessed October 27, 2021.
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