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A 15-year single centre retrospective study of antiphospholipid syndrome patients from Northern Malaysia
; Alam, Fahmida ; Gan, Siew Hua ; Sasongko, Teguh Haryu ; Wan Ghazali, Wan Syamimee ; Wong, Kah Keng
Alam, Fahmida
Gan, Siew Hua
Sasongko, Teguh Haryu
Wan Ghazali, Wan Syamimee
Wong, Kah Keng
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2017-08-01
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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.
Citation
Islam MA, Alam F, Gan SH, Sasongko TH, Wan Ghazali WS, Wong KK. A 15-year single centre retrospective study of antiphospholipid syndrome patients from Northern Malaysia. Malays J Pathol. 2017 Aug;39(2):123-133. PMID: 28866693.
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28866693 (pubmed)
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en
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© 2017 The Authors. Published by Malaysian Journal of Pathology. This is an open access article available under a Creative Commons licence.
The published version can be accessed at the following link on the publisher’s website: https://www.mjpath.org.my/2017/v39n2/antiphospholipid-syndrome.pdf