Title: THE MULTIDISCIPLINARY APPROACH TO THE PATIENTS WITH ANTIPHOSPHOLIPID SYNDROME

Biography:

Ljudmila Stojanovich received her Ph.D. in Medicine, with the thesis "Neuropsychiatric manifestations in patients with Systemic Lupus Erythematousus" in 1999. She is the scientific director in the Bezhanijska Kosa, University Medical Center of Belgrade University, where she is currently a Full Research Professor. Dr. StoLjudmila Stojanovich received her Ph.D. in Medicine, with the thesis "Neuropsychiatric manifestations in patients with Systemic Lupus Erythematousus" in 1999. She is the scientific director in the Bezhanijska Kosa, University Medical Center of Belgrade University, where she is currently a Full Research Professor. Dr. Stojanovich's research focuses on Systemic Lupus Erythematosus, Antiphospholipid Syndrome, and Vaccination in patients with Autoimmune Rheumatic diseases. She is an author of three monographs and of about 250 articles on various aspects of Autoimmune Rheumatic disorders, published in international and domestic journals and in conference proceedings. She is in Editorial Boards (Editorial Boards LUPUS (LONDON). /Reviewer in the "CURRENT CONTENTS" or "Science citation index", like LUPUS REWIEWER DATABAS, Cellular, and Molecular Neurobiology.janovich's research focuses on Systemic Lupus Erythematosus, Antiphospholipid Syndrome, and Vaccination in patients with Autoimmune Rheumatic diseases. She is an author of three monographs and of about 250 articles on various aspects of Autoimmune Rheumatic disorders, published in international and domestic journals and in conference proceedings. She is in Editorial Boards (Editorial Boards LUPUS (LONDON). /Reviewer in the "CURRENT CONTENTS" or "Science citation index", like LUPUS REWIEWER DATABAS, Cellular, and Molecular Neurobiology.

Abstract

AIM: The aim of this study was to investigate multidisciplinary approach to the patients with antiphospholipid syndrome (APS).

PATIENTS AND METHODS: Our study includes a total of 508 APS patients; 520 were PAPS patients (283 female and 177 male, mean age 44.0±12.9), while 148 had APS associated with SLE (133 female and 15 male, mean age 47.7±14.8). The diagnosis of APS was made by the presence of aPL and other diagnostic criteria.

RESULTS: In our cohort SAPS patients had significantly higher prevalence of aCL IgG, aCL IgM and aß₂GPI IgG. Thrombosis was diagnosed in 46.5% patients. Pseudoinfective endocarditis was observed in 12.8% secondary APS patients and 3.1% in primary APS patients (p=0.004). Presence of ß2GPI IgG was significantly related to stroke, and overall ß2GPI (IgG and IgM) positivity was significantly related to TIA in SAPS patients. Valvular manifestations were significantly related to TIA in both groups of patients and were independent risk factors for TIA in PAPS (OR 3.790 CI 1.597-8.998 p=0.003: table 2). In PAPS, epilepsy correlated with ß₂GPI-IgM, migraine with aCL-IgM, thrombocytopenia with aCL-IgM, aCL-IgG, anti ß₂GPI-IgG and LA. Livedo reticularis was more prominent in PAPS with high levels of aCL-IgG. Skin ulcerations were more prevalent in aCL-IgM positive SAPS patients and epilepsy more frequently had high levels of anti ß₂GPI-IgG in SAPS.

CONCLUSION: In this cross-section analysis of a large cohort of APS patients we analyzed that APS patients can be presented with a wide variety of thrombotic and nonthrombotic manifestations. The key the success is multidisciplinary approach in all time of patient’s life.