CẬP NHẬT CHẨN ĐOÁN HỘI CHỨNG KHÁNG PHOSPHOLIPID
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Tóm tắt
Tiêu chuẩn phân loại APS của ACR/EULAR năm 2023 đã đưa ra hệ thống phân loại, tính điểm bao gồm cả các tiêu chí không huyết khối, giảm thời gian xuất hiện aPL xuống còn 3 năm so với tiêu chuẩn Sapporo sửa đổi năm 2006. Tuy nhiên, một số trường hợp bệnh nhân có các đặc điểm lâm sàng của APS nhưng dương tính aPL tạm thời hoặc âm tính với aPL dai dẳng, vì vậy định nghĩa về APS huyết thanh âm tính được đề xuất và chẩn đoán thường bằng phương pháp loại trừ. Do đó, trong bài này chúng tôi đưa ra những điểm cập nhật mới, đánh giá hiệu quả của tiêu chuẩn ACR/EULAR 2023 cũng như đưa ra các bằng chứng về aPL không có tiêu chí được nghiên cứu, liên quan của chúng với các đặc điểm lâm sàng trong bối cảnh APS và APS huyết thanh âm tính.
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Từ khóa
HỘI CHỨNG KHÁNG PHOSPHOLIPID, CHẨN ĐOÁN HỘI CHỨNG KHÁNG PHOSPHOLIPID
Tài liệu tham khảo
1. Barbhaiya M, Zuily S, Naden R et al. The 2023 ACR/EULAR antiphospholipid syndrome classification criteria. Annals of the Rheumatic Diseases 2023;82(10):1258-1270. https://doi.org/10.1002/art.42624
2. Wilson WA, Gharavi AE, Koike T et al. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an international workshop. Arthritis Rheum 1999;42(7):1309-1311. https://doi.org/10.1002/1529-0131(199907)42:7<13C1309::AID-ANR1>3E3.0.CO;2-F
3. Miyakis S, Lockshin MD, Atsumi T et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4(2):295-306. https://doi.org/10.1111/j.1538-7836.2006.01753.x
4. Toubi E, Shoenfeld Y. Livedo reticularis as a criterion for antiphospholipid syndrome. Clin Rev Allergy Immunol 2007;32(2):138-144. https://doi.org/10.1007/s12016-007-0004-0
5. Francès C, Niang S, Laffitte E et al. Dermatologic manifestations of the antiphospholipid syndrome: two hundred consecutive cases. Arthritis Rheum 2005;52(6):1785-1793. https://doi.org/10.1002/art.21041
6. Sciascia S, Amigo MC, Roccatello D et al. Diagnosing antiphospholipid syndrome: “extra-criteria” manifestations and technical advances. Nat Rev Rheumatol 2017;13(9):548-560. https://doi.org/10.1038/nrrheum.2017.124
7. Cervera R, Tektonidou MG, Espinosa G et al. Task Force on Catastrophic Antiphospholipid Syndrome (APS) and Non-criteria APS Manifestations (I): catastrophic APS, APS nephropathy and heart valve lesions. Lupus 2011;20(2):165-173. https://doi.org/10.1177/0961203310395051
8. Krause I, Blank M, Fraser A et al. The association of thrombocytopenia with systemic manifestations in the antiphospholipid syndrome. Immunobiology 2005;210(10):749-754. https://doi.org/10.1016/j.imbio.2005.10.005
9. Zen M, Loredo Martinez M, Benvenuti F et al. Prevalence, outcome and management of patients with SLE and secondary antiphospholipid antibody syndrome after aPL seroconversion. Rheumatology 2021;60(3):1313-1320. https://doi.org/10.1093/rheumatology/keaa463
10. Hughes G, Khamashta M. Seronegative antiphospholipid syndrome. Ann Rheum Dis 2003;62(12):1127. https://doi.org/10.1136/ard.2003.006163
11. Bradacova P, Slavik L, Ulehlova J et al. Current Promising Biomarkers and Methods in the Diagnostics of Antiphospholipid Syndrome: A Review. Biomedicines 2021;9(2):166. https://doi.org/10.3390/biomedicines9020166
12. Radin M, Cecchi I, Roccatello D et al. Prevalence and Thrombotic Risk Assessment of Anti-β2 Glycoprotein I Domain I Antibodies: A Systematic Review. Semin Thromb Hemost 2018;44(5):466-474. https://doi.org/10.1055/s-0037-1603936
13. Tonello M, Mattia E, Del Ross T et al. Clinical value of anti-domain I-β2Glycoprotein 1 antibodies in antiphospholipid antibody carriers. A single centre, prospective observational follow-up study. Clin Chim Acta 2018;485:74-78. https://doi.org/10.1016/j.cca.2018.06.037
14. Pignatelli P, Ettorre E, Menichelli D et al. Seronegative antiphospholipid syndrome: refining the value of “non-criteria” antibodies for diagnosis and clinical management. Haematologica 2020;105(3):562-572. https://doi.org/10.3324/haematol.2019.221945
15. Murthy V, Willis R, Romay-Penabad Z et al. Value of Isolated IgA anti-β2GPI Positivity in the Diagnosis of the Antiphospholipid Syndrome. Arthritis Rheum 2013;65(12):3186-3193. https://doi.org/10.1002/art.38131
16. Pericleous C, Ferreira I, Borghi O et al. Measuring IgA Anti-β2-Glycoprotein I and IgG/IgA Anti-Domain I Antibodies Adds Value to Current Serological Assays for the Antiphospholipid Syndrome. PLoS One 2016;11(6):e0156407. https://doi.org/10.1371/journal.pone.0156407
17. Ortona E, Capozzi A, Colasanti T et al. Vimentin/cardiolipin complex as a new antigenic target of the antiphospholipid syndrome. Blood 2010;116(16):2960-2967. https://doi.org/10.1182/blood-2010-04-279208
18. Žigon P, Perdan Pirkmajer K, Tomšič M et al. Anti-Phosphatidylserine/Prothrombin Antibodies Are Associated with Adverse Pregnancy Outcomes. J Immunol Res 2015;2015:975704. https://doi.org/10.1155/2015/975704
19. Fabris M, Giacomello R, Poz A et al. The introduction of anti-phosphatidylserine/prothrombin autoantibodies in the laboratory diagnostic process of anti-phospholipid antibody syndrome: 6 months of observation. Auto Immun Highlights 2014;5(2):63-67. https://doi.org/10.1007/s13317-014-0061-3
2. Wilson WA, Gharavi AE, Koike T et al. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an international workshop. Arthritis Rheum 1999;42(7):1309-1311. https://doi.org/10.1002/1529-0131(199907)42:7<13C1309::AID-ANR1>3E3.0.CO;2-F
3. Miyakis S, Lockshin MD, Atsumi T et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4(2):295-306. https://doi.org/10.1111/j.1538-7836.2006.01753.x
4. Toubi E, Shoenfeld Y. Livedo reticularis as a criterion for antiphospholipid syndrome. Clin Rev Allergy Immunol 2007;32(2):138-144. https://doi.org/10.1007/s12016-007-0004-0
5. Francès C, Niang S, Laffitte E et al. Dermatologic manifestations of the antiphospholipid syndrome: two hundred consecutive cases. Arthritis Rheum 2005;52(6):1785-1793. https://doi.org/10.1002/art.21041
6. Sciascia S, Amigo MC, Roccatello D et al. Diagnosing antiphospholipid syndrome: “extra-criteria” manifestations and technical advances. Nat Rev Rheumatol 2017;13(9):548-560. https://doi.org/10.1038/nrrheum.2017.124
7. Cervera R, Tektonidou MG, Espinosa G et al. Task Force on Catastrophic Antiphospholipid Syndrome (APS) and Non-criteria APS Manifestations (I): catastrophic APS, APS nephropathy and heart valve lesions. Lupus 2011;20(2):165-173. https://doi.org/10.1177/0961203310395051
8. Krause I, Blank M, Fraser A et al. The association of thrombocytopenia with systemic manifestations in the antiphospholipid syndrome. Immunobiology 2005;210(10):749-754. https://doi.org/10.1016/j.imbio.2005.10.005
9. Zen M, Loredo Martinez M, Benvenuti F et al. Prevalence, outcome and management of patients with SLE and secondary antiphospholipid antibody syndrome after aPL seroconversion. Rheumatology 2021;60(3):1313-1320. https://doi.org/10.1093/rheumatology/keaa463
10. Hughes G, Khamashta M. Seronegative antiphospholipid syndrome. Ann Rheum Dis 2003;62(12):1127. https://doi.org/10.1136/ard.2003.006163
11. Bradacova P, Slavik L, Ulehlova J et al. Current Promising Biomarkers and Methods in the Diagnostics of Antiphospholipid Syndrome: A Review. Biomedicines 2021;9(2):166. https://doi.org/10.3390/biomedicines9020166
12. Radin M, Cecchi I, Roccatello D et al. Prevalence and Thrombotic Risk Assessment of Anti-β2 Glycoprotein I Domain I Antibodies: A Systematic Review. Semin Thromb Hemost 2018;44(5):466-474. https://doi.org/10.1055/s-0037-1603936
13. Tonello M, Mattia E, Del Ross T et al. Clinical value of anti-domain I-β2Glycoprotein 1 antibodies in antiphospholipid antibody carriers. A single centre, prospective observational follow-up study. Clin Chim Acta 2018;485:74-78. https://doi.org/10.1016/j.cca.2018.06.037
14. Pignatelli P, Ettorre E, Menichelli D et al. Seronegative antiphospholipid syndrome: refining the value of “non-criteria” antibodies for diagnosis and clinical management. Haematologica 2020;105(3):562-572. https://doi.org/10.3324/haematol.2019.221945
15. Murthy V, Willis R, Romay-Penabad Z et al. Value of Isolated IgA anti-β2GPI Positivity in the Diagnosis of the Antiphospholipid Syndrome. Arthritis Rheum 2013;65(12):3186-3193. https://doi.org/10.1002/art.38131
16. Pericleous C, Ferreira I, Borghi O et al. Measuring IgA Anti-β2-Glycoprotein I and IgG/IgA Anti-Domain I Antibodies Adds Value to Current Serological Assays for the Antiphospholipid Syndrome. PLoS One 2016;11(6):e0156407. https://doi.org/10.1371/journal.pone.0156407
17. Ortona E, Capozzi A, Colasanti T et al. Vimentin/cardiolipin complex as a new antigenic target of the antiphospholipid syndrome. Blood 2010;116(16):2960-2967. https://doi.org/10.1182/blood-2010-04-279208
18. Žigon P, Perdan Pirkmajer K, Tomšič M et al. Anti-Phosphatidylserine/Prothrombin Antibodies Are Associated with Adverse Pregnancy Outcomes. J Immunol Res 2015;2015:975704. https://doi.org/10.1155/2015/975704
19. Fabris M, Giacomello R, Poz A et al. The introduction of anti-phosphatidylserine/prothrombin autoantibodies in the laboratory diagnostic process of anti-phospholipid antibody syndrome: 6 months of observation. Auto Immun Highlights 2014;5(2):63-67. https://doi.org/10.1007/s13317-014-0061-3