nach oben

Immunologic Research

Erschienen in:

25.01.2017 | Novel Aspects in Lupus, 2017

The role of MSCT angiography in early detection of lower limb arterial lesions in patients with antiphospholipid syndrome

verfasst von: Jovica Saponjski, Ljudmila Stojanovich, Jelena Petrovic, Dusan Saponjski

Erschienen in: Immunologic Research | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Antiphospholipid syndrome (APS) is an autoimmune disease which is characterized by arterial and venous thromboses, fetal loss, and the presence of antiphospholipid antibodies in the serum. It is characterized by accelerated atherosclerosis. Increased tendency towards thrombosis leads to the occurrence of various vascular events. The objective of our study was to determine if there are subclinical changes on lower limb arteries in APS patients and what the best diagnostic choice for their establishment is. In this study, we analyzed 50 patients with primary antiphospholipid syndrome (PAPS) and 50 patients, who have secondary antiphospholipid syndrome (SAPS). The results were compared to 50 controls. The groups were comparable with respect to age, gender, and traditional risk factors except for the lipid status, since controls had significantly higher levels of cholesterol and triglycerides. Study was conducted on 64-multi-slice computed tomography (64-MSCT), where we analyzed quantitative and morphological characteristics of blood vessel-detected lesions. Patients from the control group had statistically very significant elevated cholesterol and triglyceride levels in regard to the patients with SAPS and PAPS (p < 0.001 and p < 0.05). Analyzing percentage of diameter stenosis, we have established that lesions from group with 0–30% diameter stenosis (DS) in patients with PAPS (n = 47) and SAPS (n = 39) are more common than that in control group (n = 3, p < 0.001). The incidence of lesions higher than 70% DS in control group (n = 74) was statistically significant than that in patients with SAPS (n = 74, p < 0.05), while very statistically significant than that in patients with PAPS (n = 48, p < 0.001). Analyzing the qualitative characteristics of plaques, we have established significant higher frequency of soft tissue (n = 32) and mixed lesions (n = 36) in patients with PAPS than the calcified one (n = 7, p < 0.001). Our study showed that the subclinical manifestation of changes on lower extremity arteries is more common in patients with APS. Because of its safety and accuracy, the method of choice is 64-MSCT angiography in monitoring disease progression.

Lockshin MD, Sammartino LR, Schwartzman S. Validation of the Sapporo criteria for antiphospholipid syndrome. Arthritis Rheum. 2000;43:440–3.CrossRefPubMed

Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RH, DE Groot PG, Koike T, Meroni PL, Reber G, Shoenfeld Y, Tincani A, Vlachoyiannopoulos PG, Krilis SA. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4(2):295–306.CrossRefPubMed

Shoenfeld Y, Sherer Y, Haratz D. Atherosclerosis as an infectious, inflammatory and autoimmune disease. Trends Immunol. 2001;22:293–5.CrossRefPubMed

Ames PR, Margarita A, Sokoll KB, Weston M, Brancaccio V. Premature atherosclerosis in primary antiphospholipid syndrome: preliminary data. Ann Rheum Dis. 2005;64:315–7.CrossRefPubMed

Ruiz-Irastorza G, Crowther M, Branch W, Khamashta MA. Antiphospholipid syndrome. Lancet. 2010;376:1498.CrossRefPubMed

Rovensky J. Asheron’s syndrome—catastrophic antipospholipid syndrome. Autoimmun Rev. 2006;6:61–3.CrossRefPubMed

Shoenfeld Y, Zandman-Goddard G, Stojanovich L, et al. The mosaic of autoimmunity: hormonal and environmental factors involved in autoimmune diseases—2008. Isr Med Assoc J. 2008;10(1):8–12.PubMed

Shoenfeld Y, Gerli R, Doria A, et al. Accelerated atherosclerosis in autoimmune rheumatic diseases. Circulation. 2005;112:3337–47.CrossRefPubMed

Soltész P, Szekanecz Z, Kiss E, Shoenfeld Y. Cardiac manifestations in antiphospholipid syndrome. Autoimmun Rev. 2007;6(6):379–86.CrossRefPubMed

10.

Saponjski J, Stojanovich L, Djokovic A, Petkovic M, Mrda D. Systemic vascular diseases in the antiphospholipid syndrome. What is the best diagnostic choice? Autoimmun Rev. 2010;10:235–7.CrossRefPubMed

11.

Lalani TA, Kanne JP, Hatfield GA, Chen P. Imaging findings in systemic lupus erythematosus. Radiographics. 2004;24(4):1069–86.CrossRefPubMed

12.

Kaushik S, Federle M, Schur PH, Krishnan M, Silverman SG, Ros PR. Abdominal thrombotic and ischemic manifestations of the antiphospholipid antibody syndrome: CT findings in 42 patients. Radiology. 2001;218:768–7.CrossRefPubMed

13.

Beregi JP, Djabbari M, Desmoucelle F, Willoteaux S, Wattinne L, Louvegini S. Popliteal vascular disease: evaluation with spiral CT angiography. Radiology. 1997;203:477–83.CrossRefPubMed

14.

Verbeeck N, Cavez N, Plawny L, Weber J, Lens V. Primary aortic thrombosis: role of enhanced multislice CT demonstrated in three exceptional cases. JBR-BTR. 2014;97(2):76–80.PubMed

15.

Suzuki K, Uemura T, Kikuchi M, Ishihara Y, Ichioka S. Acute limb-threatening ischemia associated with antiphospholipid syndrome: a report of two cases. J Foot Ankle Surg. 2016;55(6):1318–22.CrossRefPubMed

16.

Crome CR, Rajagopalan S, Kuhan G, Fluck N. Antiphospholipid syndrome presenting with acute digital ischaemia, avascular necrosis of the femoral head and superior mesenteric artery thrombus. BMJ Case Rep. 2012;20:2012.

17.

Sitia S, Atzeni F, Sarzi-Puttini P, Di Bello V, Tomasoni L, Delfino L, Antonini-Canterin F, Di Salvo G, De Gennaro Colonna V, La Carrubba S, Carerj S, Turiel M. Cardiovascular involvement in systemic autoimmune diseases. Autoimmun Rev. 2009;8(4):281–6.CrossRefPubMed

18.

Langenberger H, Schillinger M, Plank C, Sabeti S, Dick P, Cejna M, Lammer J, Minar E, Loewe C. Agreement of duplex ultrasonography vs. computed tomography angiography for evaluation of native and in-stent SFA re-stenosis—findings from a randomized controlled trial. Eur J Radiol. 2012;81(9):2265–9.CrossRefPubMed

19.

Laswed T, Rizzo E, Guntern D, Doenz F, Denys A, Schnyder P, Qanadli SD. Assessment of occlusive arterial disease of abdominal aorta and lower extremities arteries: value of multidetector CT angiography using an adaptive acquisition method. Eur Radiol. 2008;18(2):263–72.CrossRefPubMed

20.

Nardi P, Pellegrino A, Romagnoli A, Mve Mvondo C, De Propris S, Sperandio M, Versaci F, Simonetti G, Chiariello L. Multidetector computed tomographic coronary angiography as an alternative to conventional coronary angiography in non-coronary surgical patients. J Cardiovasc Surg. 2011;52(3):429–35.

21.

Van den Bosch H, Westenberg J, Setz-Pels W, Kersten E, Tielbeek A, Duijm L, Post J, Teijink J, de Roos A. Prognostic value of cardiovascular MR imaging biomarkers on outcome in peripheral arterial disease: a 6-year follow-up pilot study. Int J Cardiovasc Imaging. 2016;32:1281–8.CrossRefPubMed

22.

Lin YH, Lin HH, Liu HM, Lee CW, Chen YF. Diagnostic performance of CT and MRI on the detection of symptomatic intracranial dural arteriovenous fistula: a meta-analysis with indirect comparison. Neuroradiology. 2016;58:753–63.CrossRefPubMed

23.

Cina A, Di Stasi C, Semeraro V, Marano R, Savino G, Iezzi R, Bonomo L. Comparison of CT and MR angiography in evaluation of peripheral arterial disease before endovascular intervention. Acta Radiol. 2016;57(5):547–56.CrossRefPubMed

Titel: The role of MSCT angiography in early detection of lower limb arterial lesions in patients with antiphospholipid syndrome
verfasst von: Jovica Saponjski
Ljudmila Stojanovich
Jelena Petrovic
Dusan Saponjski
Publikationsdatum: 25.01.2017
Verlag: Springer US
Erschienen in: Immunologic Research / Ausgabe 2/2017
Print ISSN: 0257-277X
Elektronische ISSN: 1559-0755
DOI: https://doi.org/10.1007/s12026-016-8887-6

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Springer Medizin

The role of MSCT angiography in early detection of lower limb arterial lesions in patients with antiphospholipid syndrome

Abstract

Neu im Fachgebiet HNO

Akuter Schwindel: Wann lohnt sich eine MRT?

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

HNO-Op. auch mit über 90?

Intrakapsuläre Tonsillektomie gewinnt an Boden

Update HNO

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2017

Prolactin has a pathogenic role in systemic lupus erythematosus

Anti-phospholipid syndrome associated with schizophrenia description of five patients and review of the literature

The microbiome and systemic lupus erythematosus

Anti-mutated citrullinated vimentin antibodies in antiphospholipid syndrome: diagnostic value and relationship with clinical features

Obstetric and perinatal outcome in anti-Ro/SSA-positive pregnant women: a prospective cohort study

Autonomic neuropathy—in its many guises—as the initial manifestation of the antiphospholipid syndrome

Neu im Fachgebiet HNO

Akuter Schwindel: Wann lohnt sich eine MRT?

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

HNO-Op. auch mit über 90?

Intrakapsuläre Tonsillektomie gewinnt an Boden

Update HNO