항인지질증후군의 임상성

Background: Antiphospholipid syndrome is characterized by arterial or venous thrombosis, recurrent fetal loss, thrombocytopenia, and presence of antiphospholipid antibody. This study was done to know the clinical and serological characteristics of antiphospholipid syndrome in Korea and to evaluate the therapeutic efficacy of prednisolone and antithrombotic agents in antiphospholipid syndrome. Methods: Clinical and laboratory features of 11 patients with antiphospholipid antibodies and histories of spontaneous abortion and thrombosis were studied. Results: Of the 11 patients, 3 were male, and 8 were female, and the ages ranged from 19 to 54 years (median, 30). 3 patients had systemic lupus erythematosus, and the other 8 fulfilled criteia for the primary antiphospholipid syndrome. Initial presentations were deep vein thrombosis in 4 patients, spontaneous abortion in 4, pulmonary embolism in 1, splenic infarct in 1, and stroke in 1. Seven of 11 patents (63.6%) had episodes of venous thrombosis, and in 2 these were accompanied by pulmonary embolism. Arterial occlusions were present in 2 patients. These comprised splenic infarct and right middle cerebral arterial occlusion. Splenic infarct was accompanied by portal vein, splenic vein, and superior mesenteric vein thrombosis. Spontaneous abortion were present in 6 patients with wide range of episodes of fetal loss (range 1-6, median 2.5). Six episodes of spontaneous abortion occurred during the second trimester and 6 during the third. Combined diseases were idiopathic thrombocytopenic purpura, liver chirrosis, iron deficiency anemia, hypertension, and mitral regurgitation. Six patients had both the lupus anticoagulant and anticardiolipin antibodies; 2 had anticardiolipin antibodies alone; and 3 had only the lupus anitcoagulant. Antinuclear antibodies (>1:40) were present in 8 of the 11 patients and anti-ds-DNA (>25 units) in 3. False positive VDRLs were noted in 3 patients, and thrombocytopenia (