Antiphospholipid Syndrome
Özet
Antiphospholipid syndrome (APS) is an autoimmune disease that effects multisystems and organs; develops as a result of antiphospholipid antibodies (aPL) dependent with vascular thromboses and/ or pregnancy complications. Firstly in the early 1980s, APS was described based on the observation that thrombosis and pregnancy losses were seen more frequently in SLE patients who had lupus anticoagulant (LA), anti-cardiolipin antibodies. The prevalence of APS is approximately 50/100 000 of the population. The prevelance of APS increases with age; the prevelance especially high in older patients with a chronic disease. Antiphospholipid syndrome can be secondary or primary; secondary APS is associated with other autoimmune disease, particularly systemic lupus erythematosus (SLE) and primary APS is assosiated no autoimmune disease. Clinical thrombotic vascular complications are often associated with antiphospholipid antibodies that can occur autoimmune disease, viral,bacterial, protozoal, fungal infections, malignancies, drug. Patients who have antiphospholipid antibodies (aPL) are at risk of developing thrombocytopenia, venous and arterial thrombosis, and recurrent fetal loss. Thrombosis can involve both arteriel and venous systems, tend to recurrence and can occur in the same system. In the studies, thrombotic manifestations of APS is seen mostly by venous thromboembolism with approximately 60% ratio. APS is a syndrome has multisystemic involvement due to acquired hypercoagulable state and associated with various thrombotic and nonthrombotic cardiac manifestations. The cardiac involvement in APS patients is seen in a wide spectrum including ischemic heart disease, right or left ventricular dysfunction, pulmonary hypertension, intracardiac thrombosis and endomyocardial fibrosis due to thrombosis in the coronary or microvascular circulation.The most common form of cardiac involvement in APS is heart valve disease. Primary and secondary cardiovascular prevention strategies should be implemented basically with lifestyle changes firstly and involved specific treatment algorithm of cardiovascular risk factors.
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