Evaluation of the severe preeclampsia classification criterion for antiphospholipid syndrome in a study of 40 patients

Arthritis Research & Therapy

Vassilis Tsatsaris¹  Emmanuelle Pannier-Metzger¹  Nathalie Morel²  Véronique Le Guern²  Anne Murarasu²  Romain Paule²  Gaelle Guettrot-Imbert²  Maddalena Larosa³  Mériem Belhocine⁴  Luc Mouthon⁵  Nathalie Costedoat-Chalumeau⁶  Jean-Charles Piette⁷  Amelia Ruffatti⁸  Andrea Doria⁸  Catherine Deneux-Tharaux⁹  Odile Souchaud-Debouverie^1,10  Nicolas Martin Silva^1,11  Michel Dreyfus^1,12 

[1] AP-HP, Cochin Broca Hôtel-Dieu Hospital, Port-Royal maternity, DHU Risk in Pregnancy, INSERM Unité 1139, Paris, France;AP-HP, Cochin Hospital, Internal Medicine Department, Centre de référence maladies auto-immunes et systémiques rares d’Ile de France, Paris, France;AP-HP, Cochin Hospital, Internal Medicine Department, Centre de référence maladies auto-immunes et systémiques rares d’Ile de France, Paris, France;Division of Rheumatology, Department of Medicine-DIMED, University of Padova, Via Giustiniani 2, 35128, Padova, Italy;AP-HP, Cochin Hospital, Internal Medicine Department, Centre de référence maladies auto-immunes et systémiques rares d’Ile de France, Paris, France;Sacré-Coeur Hospital, Internal Medicine Department, University of Montréal, Montréal, Canada;AP-HP, Cochin Hospital, Internal Medicine Department, Centre de référence maladies auto-immunes et systémiques rares d’Ile de France, Paris, France;Université de Paris, 27 Rue du Faubourg Saint Jacques, 75014, Paris, France;AP-HP, Cochin Hospital, Internal Medicine Department, Centre de référence maladies auto-immunes et systémiques rares d’Ile de France, Paris, France;Université de Paris, 27 Rue du Faubourg Saint Jacques, 75014, Paris, France;INSERM U 1153, Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France;AP-HP, Pitié-Salpétrière University Hospital, Internal Medicine and Clinical Immunology Department, Centre de référence maladies auto-immunes et systémiques rares de l’Ile de France, Paris, France;Division of Rheumatology, Department of Medicine-DIMED, University of Padova, Via Giustiniani 2, 35128, Padova, Italy;INSERM U 1153, Obstetrical, Perinatal and Paediatric Epidemiology (EPOPé research team), DHU Risks in Pregnancy, Université de Paris, Paris, France;Poitiers University Hospital, Department of Medicine, Internal Medicine Department, Paris, France;University Hospital Center of Caen, Department of Internal Medicine, Caen, France;University Hospital Center of Caen, Gynecology and Obstetrics Department, Caen, France;

关键词: Antiphospholipid syndrome;    Systemic lupus erythematosus;    Thrombosis;    Pregnancy;    Severe preeclampsia;    Classification criteria;   

DOI  :  10.1186/s13075-021-02518-7

来源: Springer

【 摘 要 】

BackgroundThe criteria for antiphospholipid syndrome (APS) include severe preeclampsia and/or placental insufficiency leading to preterm delivery before 34 weeks of gestation, but this APS manifestation has been rarely studied. Thus, we report a series of severe preeclampsia occurred in patients with APS.MethodsWe retrospectively analysed data of women with APS (Sydney criteria) who experienced severe preeclampsia with delivery before 34 weeks’ gestation between 2000 and 2017 at five French internal medicine departments and one Italian rheumatology unit.ResultsThe 40 women had a mean age of 30.5 ± 4.6 years at their first episode of preeclampsia; 21 were nulligravid (52.5%), 12 (30%) had already been diagnosed with APS, and 21 (52.5%) had a triple-positive antiphospholipid (aPL) antibody test.Preeclampsia occurred at a median gestational age of 25.5 weeks (IQR 23-29). It was associated with HELLP in 18 cases (45%), eclampsia in 6 (15%), placental abruption in 3 (7.5%), catastrophic APS in 3 (7.5%), and foetal and neonatal death in 11 and 15 cases. Overall, 14 (35%) children survived, born at a median gestational age of 31 weeks.Among other APS criteria, 16 women (40%) experienced at least one thrombosis, 17 (42.5%) an intrauterine foetal death, and 19 (47.5%) at least one episode of HELLP during follow-up (median 5 years, IQR = 2-8). None had three or more consecutive miscarriages. Notably, 12 women (30%) had systemic lupus erythematosus.ConclusionsSevere preeclampsia led to high mortality in the offspring. Almost half of these women experienced other APS features, but not three consecutive miscarriages.

【 授权许可】

CC BY