ANTIPHOSPHOLIPID SYNDROME - A SERIES OF 2 0 CASES

Objectives: We analyzed the clinical and biological characteristics as well as the clinical course and outcome observed in 20 patients with antiphospholipid antibodies and clinical signs including thrombosis or repeated spontaneous abortion to better identify the recently describ ed antiphospholipid syndrome. Methods: We retrospectively studied all patients observed in our unit from 1981 to 1992 who fulfilled the foll owing inclusion criteria: a) at least one episode of arterial or venou s thrombosis and/or repeated spontaneous abortions, b) positive for an tiphospholipid antibodies. Results: Twenty patients were included, 3 w ith systemic lupus erythematosus (according to the American Rheumatism Association criteria). Arterial or venous thrombosis occurred in 9 an d 16 respectively, including exceptional cases of cerebral phlebitis a nd thrombosis of dermal capillaries. High blood pressure was recorded in 8. Only 1 or 2 types of antiphospholipid antibodies were found in m ost patients. Anticardiolipin, a circulating anticoagulant and a false positive Bordet-Wassermann reaction were found together in only 3 out of 16. In addition, the antibody level varied independently from the thrombotic events. There was no case with a clinical course from prima ry antiphospholipid syn drome to systemic erythromatosus lupus. The ef fect to treatment on occurrence of new thrombotic events was studied. Three patients suffered one or more haemorrhagic events during antivit amin K treatment. Conclusion: It is difficult to establish a different iation between primary antiphospholipid syndrome, systemic lupus eryth ematosus and lupus like syndromes, and precise methods of identifying antiphospholipid antibodies should be further developed.