Dermatomyositis is an uncommon autoimmune condition involving skeletal muscle characterized by subacute onset of progressive weakness, intramuscular inflammatory infiltrates and the presence of myositis-specific autoantibodies.1 Immune-mediated myopathies may exert some pathogenic effects on the muscle tissue by targeting the microvasculature.1 Capillary inflammation, fragility and loss may contribute to heightened bleeding events in these patients. Here,…
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Case Report: Diagnosing Sneddon Syndrome
A 24-year-old woman presented to our rheumatology office in 2017 with a blotchy purple rash on her arms and legs. She reported no history of miscarriage or blood clots. The rash pattern was concerning for livedo reticularis or livedo racemosa, and she was noted to have an anti-nuclear antibody (ANA) titer of 1:160 with a…
Antiphospholipid Syndrome: Management & Future Directions
Three experts discuss recent developments in the diagnosis & treatment of APS & the future direction of research.
Anti-TNF Treatment Trial Encouraging for High-Risk APS Pregnancies
Early results in a phase 2 trial are finding that adding a TNF blocker to other treatment could greatly lower the risk of serious complications during pregnancy for women who have antiphospholipid syndrome with lupus anticoagulant.
Hope for Live Births in Women with Antiphospholipid Syndrome
For women with antiphospholipid syndrome (APS), treatment with a combination of heparin and aspirin during pregnancy—rather than aspirin alone—may increase live birth rates, according to new research.
Risk Assessment & Treatment in Antiphospholipid Syndrome Patients
CHICAGO—Choosing a treatment for antiphospholipid syndrome (APS) involves an array of factors, from the antibodies present to their titers to other risk factors, said Lisa Sammaritano, MD, during a guided tour of APS treatment at the 2019 ACR State-of-the-Art Clinical Symposium, held April 5–7. Dr. Sammaritano, associate attending physician at the Hospital for Special Surgery,…
Risk Assessment & Treatment in APS Patients
The pathogenesis of antiphospholipid syndrome (APS) is complicated and may involve local inflammation, vasculopathy, pregnancy complications and thrombosis. During the 2019 ACR State-of-the-Art Clinical Symposium, Lisa Sammaritano, MD, addressed the risk assessment and treatment of APS patients…
Antiphospholipid Antibody Syndrome: Much Remains to be Learned
CHICAGO—Antiphospholipid antibody syndrome (APS) mainly affects young women, but can also affect men. APS patients test positive for multiple antibodies, including lupus anticoagulant (LAC), anti-cardiolipin and/or anti-beta2-glycoprotein I. These antibodies are diagnostic of APS, and they place the patient at increased risk for thrombosis and, in women, pregnancy morbidity. Women with LAC or those who…
Case Report: A Behçet’s Patient Develops Cerebral Venous Sinus Thrombi
A 39-year-old woman presented at the emergency department with three weeks of progressive, constant and pulsatile right-sided headache. She said her headache was worse in the morning and when she would bend forward. She reported associated nausea and vomiting. On initial assessment, she did not have any focal neurological deficits. Her medical history was significant for…
Antiphospholipid Syndrome: The Risk of Travel at High Altitudes
Antiphospholipid syndrome (APS) is an autoimmune clotting disorder that may present catastrophically with multiple thromboses over a short period of time. In this article, we examine the case of a woman with undiagnosed APS whose first symptoms presented during a long-haul flight. A review of the literature on thrombosis at high altitudes and during long…