Title: Diagnostic and Management challenges in antiphospholipid syndrome

Biography:

Ljudmila Stojanovich received her Ph.D. in Medicine 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. She is an author of three monographs and of about 250 articles, published in international and domestic journals and in conference proceedings.  She is in Editorial Boards (Editorial Boards LUPUS (LONDON). She is a member of number International Project, like of “the European Forum on Antiphospholipid Antibodies”. She was in Invited Speaker for many lectures in Congresses and Symposia; organizer and Chairman of many Seminars and Symposia; and member of the Steering Committee of the “EULAR recommendations for the prevention and management of adult antiphospholipid syndrome".

Abstract

Introduction:Antiphospholipid syndrome (APS), may manifest itself as primary (PAPS) or secondary (SAPS).  Repeated thromboses are the most frequent clinical manifestation of APS in the presence of antiphospholipid antibodies (aPL).  APS patients suffer from various non-thrombotic manifestations, including thrombocitopenia. Methods: Our prospective study comprises of 468 patients: 318 with primary, 132 with secondary APS. Results:Thrombosis was diagnosed in 46.5% patients, with higher prevalence in PAPS compared to SAPS patients. There was similar prevalence of arterial thrombosis in PAPS and SAPS groups (34.6% and 34%, respectively, p=0.932) although venous thrombosis was more frequent in PAPS (25.9% and 8.5%, respectively, p=0.001). Thrombosis was observed in 92 (55.8%) patients who had more than one type of antibodies (category I), in 13 (41.9%) patients with category IIa, in 19 (46.3%) patients with category IIb, and in 73 (44.2%) patients with category IIc (p=0.10). The patients with thrombosis were older than those without thrombosis (49.8 and 39.8 years, respectively, p=0.001). Overall, older age was a risk factor for thrombosis. The prevalence of venous thrombosis was higher in the PAPS group, but with lower frequency than in literature data. Any aPL type and level is a risk factor for thrombosis. Thrombocytopenia more likely occurs in patients with both high aCL IgG and ß₂GPI IgG levels.