Demetrio Pablo Rosalia, Muñoz Pedro, López-Hoyos Marcos, Calvo Vanesa, Riancho Leyre, Martínez-Taboada Victor Manuel
Servicio de Oftalmología, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Facultad de Medicina, Universidad de Cantabria, Santander, España.
Gerencia de Atención Primaria, Servicio Cántabro de Salud, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Facultad de Medicina, Universidad de Cantabria, Santander, España.
Med Clin (Barc). 2017 May 10;148(9):394-400. doi: 10.1016/j.medcli.2016.11.026. Epub 2017 Jan 30.
The antiphospholipid syndrome (APS) is an acquired immune disorder defined by the presence of thrombosis (arterial and/or venous) and/or pregnancy morbidity along with the presence of positive antiphospholipid antibodies (aPL). There is a clear relationship between aPL and some events not included in the clinical criteria, including haematologic.
a) to study the probability of developing clinical APS in patients with positive aPL and thrombopenia; b) to identify potential risk factors for thrombosis, and c) to study the association between thrombocytopenia and aPL.
A retrospective study of 138 patients with positive aPL without fulfilling clinical criteria for APS. Thrombocytopenia was defined as a platelet count≤100,000/μl. Patients with other causes of thrombocytopenia were excluded.
Seventeen of the 138 (12%) patients in the study had thrombocytopenia. The mean platelet count was 60,000/μl. The risk of developing thrombocytopenia was higher in smokers (OR 2.8; P=.044), in those with lupus anticoagulant (OR 13.5; P<.001) and those with higher burden of aPL (OR 50.8; P<.001). After a mean follow-up of 146±60.3 months, 5 patients with thrombocytopenia (29.4%) developed thrombosis.
In our series, the incidence of thrombocytopenia is 12%. aPL-positive patients who develop thrombocytopenia have a potential risk of developing thrombosis. Tobacco could be a risk factor for thrombocytopenia. Autoantibodies load is a risk factor for the development of thrombocytopenia.
抗磷脂综合征（APS）是一种获得性免疫疾病，其定义为存在血栓形成（动脉和/或静脉）和/或妊娠并发症，同时伴有抗磷脂抗体（aPL）阳性。aPL与一些未纳入临床标准的事件之间存在明确关联，包括血液学方面的事件。
a）研究aPL阳性且血小板减少的患者发生临床APS的可能性；b）确定血栓形成的潜在危险因素；c）研究血小板减少与aPL之间的关联。
对138例未达到APS临床标准的aPL阳性患者进行回顾性研究。血小板减少定义为血小板计数≤100,000/μl。排除其他导致血小板减少的原因的患者。
研究中的138例患者中有17例（12%）出现血小板减少。平均血小板计数为60,000/μl。吸烟者发生血小板减少的风险更高（比值比2.8；P = 0.044），狼疮抗凝物阳性者（比值比13.5；P < 0.001）以及aPL负担较高者（比值比50.8；P < 0.001）也是如此。平均随访146±60.3个月后，5例血小板减少患者（29.4%）发生了血栓形成。
在我们的系列研究中，血小板减少的发生率为12%。发生血小板减少的aPL阳性患者有发生血栓形成的潜在风险。烟草可能是血小板减少的一个危险因素。自身抗体负荷是血小板减少发生的一个危险因素。
