A PROSPECTIVE EPIDEMIOLOGIC-STUDY ON THE OCCURRENCE OF ANTIPHOSPHOLIPID ANTIBODY - THE MONTPELLIER ANTIPHOSPHOLIPID (MAP) STUDY

The objective of this study was to determine the prevalence and clinic al significance of elevated antiphospholipid antibodies (APA) in a lar ge series of patients admitted to a departament of Internal Medicine. At the end of entry phase, 1014 patients were tested (488 males-526 fe males, mean age: 66,7 years, range 18-97). Seventy-two (7.1 %) patient s were found APA positive at least once: 44 males and 28 females, mean age 69 years, range 23 to 94. Twenty fulfilled the criteria of Primar y Antiphospholipid Antibody Syndrome: 10 patients were referred for de ep vein thrombosis, 3 had history of deep vein thrombosis, 1 had both arterial thrombosis and a history of venous thrombosis; 2 had thromboc ytopenia; 3 had stroke, 1 had a history of s troke. One patient had SL E according to ARA classification. The most frequent associated diseas e was cancer: 14 patients, 9 had evolutive malignant disease, 5 were i n clinical remission of neoplasia. Other clinical conditions included chronic and/or acute alcoholic intoxication (n=8), severe atherosclero sis (n=4), leg ulcer (n=4). Insufficient data are available about the evolution, but 7 patients died in the year following diagnosis. Eight patients had fluctuations in APA detection: 2 initially APA positive b ecame negative, 5 initially negative became positive and I patient was alternatively positive, negative and positive without steroid treatme nt. Thus, as expected, APA occur in a variety of clinical disorders. T he association with cancer or alcoholic intoxication deserves further investigations.