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Antiphospholipid syndrome in Latin American patients: clinical and immunologic characteristics and comparison with European patients

Autoimmune Diseases Unit, Instituto Mexicano del Seguro Social, Puebla, Mexico, Department of Rheumatology, School of Medicine, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico

C. Galarza

Unidad de Enfermedades Reumáticas y Autoinmunes (UNERA), Hospital Monte Sinaí, Cuenca, Ecuador

M. Gómez-Ponce

Autoimmune Diseases Unit, Instituto Mexicano del Seguro Social, Puebla, Mexico

R. Cervera

Department of Autoimmune Diseases, Institut Clínic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Catalonia, Spain

J. Rojas-Rodríguez

Department of Rheumatology, School of Medicine, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico

G. Espinosa

Department of Autoimmune Diseases, Institut Clínic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Catalonia, Spain, gespino{at}clinic.ub.es

S. Bucciarelli

Department of Autoimmune Diseases, Institut Clínic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Catalonia, Spain

J.A. Gómez-Puerta

Department of Autoimmune Diseases, Institut Clínic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Catalonia, Spain

A. Bové

Department of Autoimmune Diseases, Institut Clínic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Catalonia, Spain

R.O. Escárcega

Autoimmune Diseases Unit, Instituto Mexicano del Seguro Social, Puebla, Mexico

J. Font

Department of Autoimmune Diseases, Institut Clínic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Catalonia, Spain

The objective of this study was to analyse the prevalence and characteristics of the main clinical and immunological manifestations at the onset and during the evolution of the disease in a cohort of patients from Latin America (mainly of mestizo origin) and to compare the Latin American with the European patients. Clinical and serological characteristics of 100 APS patients from Mexico and Ecuador were collected in a protocol form that was identical to that used to study the `Euro-Phospholipid' cohort. The cohort consisted of 93 female patients (93.0%) and seven (7.0%) male patients. There were 91 mestizos (91.0%), seven whites (7.0%) and two Amerindians (2.0%). The most common manifestations were livedo reticularis (40.0%), migraine (35.0%), inferior extremity deep vein thrombosis (32.0%), thrombocytopenia (28.0%) and hemolytic anemia (20.0%). Several clinical manifestations were more prevalent in Latin American than in European patients and they included mainly neurological (migraine, transient global amnesia, acute ischemic encephalopathy, amaurosis fugax) and cutaneous (livedo reticularis, skin ulcerations, superficial cutaneous necrosis, multiple subungual splinter hemorrhages) manifestations as well as hemolytic anemia. The APS has a wide variety of clinical and immunological manifestations at the onset and during the evolution of the disease and the ethnic origin in addition to environmental and socioeconomic factors can modify the disease expression. Lupus (2007) 16, 366—373.

Key Words: anticardiolipin antibodies • antiphospholipid antibodies • antiphospholipid syndrome • ethnicity • lupus anticoagulant

Lupus, Vol. 16, No. 5, 366-373 (2007)
DOI: 10.1177/0961203307077108


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