Ramos-Casals Manuel, Cervera Ricard, Lagrutta Mariana, Medina Francisco, García-Carrasco Mario, de la Red Gloria, Bové Albert, Ingelmo Miguel, Font Josep
Department of Autoimmune Diseases, Institut d'Investigacions Biomediques August Pi i Sunyer, Hospital Clínic, School of Medicine, University of Barcelona, Spain.
Clin Infect Dis. 2004 Apr 1;38(7):1009-16. doi: 10.1086/382537. Epub 2004 Mar 15.
We analyzed the spectrum of clinical features related to antiphospholipid syndrome (APS) in patients with chronic viral infections, such as hepatitis C virus (HCV) infection and human immunodeficiency virus (HIV) infection. We selected patients from the HISPAMEC registry who repeatedly tested positive for antiphospholipid antibodies (aPL) and who had features of APS, and we searched the MEDLINE database for additional cases. A total of 82 patients were included (45 had chronic HCV infection, 32 had HIV infection, and 5 had HCV-HIV coinfection). The main features of APS were avascular bone necrosis (20 patients), peripheral thrombosis (17), thrombocytopenia (15), neurologic features (13), cardiac manifestations (12), pulmonary embolism (9), gastrointestinal manifestations (8), and cutaneous manifestations (8). The main APS-related features in HCV-infected patients were intraabdominal thrombosis and myocardial infarction, whereas, in HIV-infected patients, the main features were avascular bone and cutaneous necrosis. These viruses might act in some patients as chronic triggering agents that induce a heterogeneous, atypical presentation of APS.
