The relevance of "non-criteria" clinical manifestations of antiphospholipid syndrome: 14th International Congress on Antiphospholipid Antibodies Technical Task Force Report on Antiphospholipid Syndrome Clinical Features

Mirhelen M. Abreu, Adriana Danowski, Denis G. Wahl, Mary Carmen Amigo, Maria Tektonidou, Marcelo S. Pacheco, Norma Fleming, Vinicius Domingues, Savino Sciascia, Julia O. Lyra, Michelle Petri, Munther Khamashta, Roger A. Levy

Research output: Contribution to journalReview article

Abstract

The purpose of this task force was to critically analyze nine non-criteria manifestations of APS to support their inclusion as APS classification criteria. The Task Force Members selected the non-criteria clinical manifestations according to their clinical relevance, that is, the patient-important outcome from clinician perspective. They included superficial vein thrombosis, thrombocytopenia, renal microangiopathy, heart valve disease, livedo reticularis, migraine, chorea, seizures and myelitis, which were reviewed by this International Task Force collaboration, in addition to the seronegative APS (SN-APS). GRADE system was used to evaluate the quality of evidence of medical literature of each selected item. This critical appraisal exercise aimed to support the debate regarding the clinical picture of APS. We found that the overall GRADE analysis was very low for migraine and seizures, low for superficial venous thrombosis, thrombocytopenia, chorea, longitudinal myelitis and the so-called seronegative APS and moderate for APS nephropathy, heart valve lesions and livedo reticularis. The next step can be a critical redefinition of an APS gold standard, for instance derived from the APS ACTION registry that will include not only current APS patients but also those with antiphospholipid antibodies not meeting current classification criteria.

Original languageEnglish (US)
Pages (from-to)401-414
Number of pages14
JournalAutoimmunity Reviews
Volume14
Issue number5
DOIs
StatePublished - May 1 2015

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Keywords

  • Accuracy
  • Antiphospholipid Syndrome
  • Clinical features
  • GRADE system
  • Non-criteria manifestations

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Abreu, M. M., Danowski, A., Wahl, D. G., Amigo, M. C., Tektonidou, M., Pacheco, M. S., Fleming, N., Domingues, V., Sciascia, S., Lyra, J. O., Petri, M., Khamashta, M., & Levy, R. A. (2015). The relevance of "non-criteria" clinical manifestations of antiphospholipid syndrome: 14th International Congress on Antiphospholipid Antibodies Technical Task Force Report on Antiphospholipid Syndrome Clinical Features. Autoimmunity Reviews, 14(5), 401-414. https://doi.org/10.1016/j.autrev.2015.01.002