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Aneurysms in primary antiphospholipid syndrome: a case-based review

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Abstract

To perform a review on patients with primary antiphospholipid syndrome (APS) who developed an aneurysm. A review of articles published in PubMed/MEDLINE, LILACS, and SciELO dating from 1966 to October 2020 was conducted using the following search words: “Antiphospholipid syndrome” and “aneurysm.” No language limitation was applied. This review includes 10 articles on APS patients and aneurysms entailing 14, including our additional case. Age varied from 20 to 76 years old, and female sex was predominant and presented in 54%. The arterial vessels compromised were aorta (n = 6), coronary (n = 2), hepatic (n = 2), renal (n = 2), middle cerebral artery (n = 2), and then splenic, superior mesenteric, pancreatic, retinal, jejunal, carotid, and pulmonary. Frequencies of antiphospholipid antibodies were described as follows: lupus anticoagulant (n = 6), anti-beta2-glycoprotein I (n = 4), IgG and IgM anticardiolipin (n = 3), IgG anticardiolipin (n = 3), and antiphosphatidylserine (n = 2). The presence of APS manifestations was distributed as deep venous thrombosis (n = 4), recurrent abortions (n = 4), pulmonary embolism (n = 3), stroke, or transitory ischemic accident (n = 3), and then limb ischemia and thrombocytopenia. The therapies used in these patients were warfarin, antiplatelet agent, vascular surgery, heparin, hydroxychloroquine, coil embolism, and intravenous immunoglobulin. Regarding outcomes, 5 patients were alive, and 3 were dead. This article reviewed all published cases on APS and aneurysm and showed that women who presented with abortions and deep venous thromboses with a lupus anticoagulant are those patients more commonly affected by aneurysms in APS.

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Authors and Affiliations

  1. Institute for Health Sciences from Federal University of Bahia, Rua das Violetas, 42, ap. 502, Pituba, Salvador, Bahia, Brazil

    Jozélio Freire de Carvalho

  2. Chaim Sheba Medical Center The Zabludowicz Center for Autoimmune Diseases Tel Hashomer, Ramat Gan, Israel

    Yehuda Shoenfeld

  3. I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia

    Yehuda Shoenfeld

Authors
  1. Jozélio Freire de Carvalho
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  2. Yehuda Shoenfeld
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JFC: conception, analysis, writing, interpretation, revision, submission

YS: analysis, writing, interpretation, revision, submission

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Correspondence to Jozélio Freire de Carvalho.

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The authors declare that they followed the World Medical Association Declaration of Helsinki in this study. An informed consent was obtained from the patient for publication of his case.

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de Carvalho, J.F., Shoenfeld, Y. Aneurysms in primary antiphospholipid syndrome: a case-based review. Clin Rheumatol 40, 3001–3006 (2021). https://doi.org/10.1007/s10067-020-05564-9

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  • DOI: https://doi.org/10.1007/s10067-020-05564-9

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