A 15-year single centre retrospective study of antiphospholipid syndrome patients from Northern Malaysia
- Author:
Md. Asiful Islam
;
Fahmida Alam
;
Siew Hua Gan
;
Teguh Haryo Sasongko
;
Wan Syamimee Wan Ghazali
;
Kah Keng Wong
- Publication Type:Original Article
- Keywords:
antiphospholipid syndrome;
antiphospholipid antibodies;
pregnancy morbidity;
menorrhagia;
ovarian cyst;
anticoagulants;
retrospective study
- From:The Malaysian Journal of Pathology
2017;39(2):123-133
- CountryMalaysia
- Language:English
-
Abstract:
Background: Antiphospholipid syndrome (APS) is an autoimmune disorder characterised by
thrombosis and/or pregnancy morbidity in the presence of antiphospholipid antibodies (aPLs) based
on the Sydney criteria. We aimed to explore the clinico-laboratory features and treatment strategies
of APS patients retrospectively. Methodology: The medical records of APS patients registered under
Hospital Universiti Sains Malaysia (Kelantan state) between 2000 and 2015 were reviewed. Results:
A total of 17 APS subjects (age 40.7 ± 12.8 years) including 11 primary (64.7%) and six secondary
APS (35.3%) patients were identified. The follow-up period was 9.5 ± 6.7 years with male:female
ratio of 1.0:4.7. Pregnancy morbidity was the most common clinical manifestation (11/14; 78.6%)
followed by recurrent venous thrombosis (10/17; 58.8%). For other clinical features, menorrhagia
was the most frequently observed manifestation (4/14; 28.6%) followed by aPLs-associated
thrombocytopenia (4/17; 23.5%) and ovarian cyst (3/14; 21.4%). LA and aCL were positive in 94.1%
(16/17) and 81.8% (9/11) of the patients, respectively. APTT value (76.7 ± 17.0 sec) was significantly
high (p < 0.05). Low intensity warfarin alone was successful to maintain target INR (2.0 - 3.0)
and prevent recurrence of thrombosis. Conclusion: The tendency of pregnancy morbidity in this
cohort of Malaysian Kelantanese APS patients was high compared to other previously reported APS
cohorts. Low intensity warfarin was successful in preventing recurrence of thrombosis, however,
APS women receiving long-term anticoagulants should be monitored for possible occurrence of
menorrhagia and ovarian cysts.
