ANTIPHOSPHOLIPID SYNDROME: FROM DIAGNOSIS TO TREATMENT
Autori:
Duška Martinović, Mislav Radić, Damir Fabijanić, Antonija Fabijanić
Sažetak
Sažetak. Antifosfolipidni sindrom (APS) protrombotski je poremećaj posredovan specifičnim antifosfolipidnim protutijelima (aPL). Bolesnici s APS-om imaju povećan rizik od nastanka arterijske i/ili venske tromboembolije. Ipak, unatoč brojnim istraživanjima stvarna povezanost između aPL i nastanka tromboembolije još je nepoznata. Naime, nije sa sigurnošću potvrđeno jesu li antifosfolipidna protutijela tek biljeg protrombotskog stanja ili pak aktivni sudionik u procesu trom¬bogeneze. Značajan postotak bolesnika s aPL nikad ne dobije trombotsku ili embolijsku komplikaciju. Stoga do danas nisu donesene smjernice za primarnu profilaksu tromboembolija u pacijenata s povećanim razinama aPL. Nasuprot tomu, u sekundarnoj prevenciji smjernice nalažu primjenu trajnog antikoagulantnog liječenja. U ovom pregledu iznosimo trenutačne spoznaje o trajanju, jačini i primjerenosti antikoagulantne i/ili antitrombocitne terapije u bolesnika s različitim kliničkim manifestacijama APS-a.
Summary
Summary. Antiphospholipid syndrome (APS) is a prothrombotic disorder mediate with characteristic antiphospholipide antibodies (aPL). Patients with APS have got higher risk for arterial or venous thromboembolism. However, in spite of numerous studies the true association between aPL and first thromboembolism is still unknown. It is not clear whether the presence of aPL is a risk factor for thromboembolism or do they directly take a part in thrombogenesis. Many patients with aPL never experienced thromboembolic event. So far there is not any recommendation for primary prophylaxis of thromboembolic complications in such patients. Guidelines for secondary prevention recommended permanent anticoagulation. In this paper we offer a concise review of the vast body of published work and appropriateness of anticoagulation or antiplatelat therapy in various clinical subcategories of this syndrome.
