Autoimmune diseases and pregnancy

Publication date: Available online 11 September 2019Source: Best Practice &Research Clinical Endocrinology &MetabolismAuthor(s): Angela Tincani, Cecilia Nalli, Jamilya Khizroeva, Victoria Bitsadze, Andrea Lojacono, Laura Andreoli, Yehuda Shoenfeld, Alexander MakatsariyaPregnancy in autoimmune diseases remains an argument of debate. In last years great improvements were done and with the correct medical support women with disease such as Systemic Lupus Erythematosus or Antiphospholipid Syndrome can afford a pregnancy and have healthy babies. The starting point is a good counselling. Women should be informed about risks that can occur taking some medications while pregnant and, on the other hand, that there are medications that can be safety assumed during pregnancy. Furthermore, there are known maternal risks factor such as the presence of antiphospholipid antibodies or anti-Ro/SSA antibodies that must be carefully manage by both rheumatologists and obstetrics. In addition, also disease activity during pregnancy can represent an issue. For all these reason, a multidisciplinary approach is mandatory in order to give our patients an optimal medical support, before, during and after pregnancy.
Source: Best Practice and Research Clinical Endocrinology and Metabolism - Category: Endocrinology Source Type: research

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Publication date: Available online 8 October 2019Source: Best Practice &Research Clinical Obstetrics &GynaecologyAuthor(s): Lisa R. SammaritanoAbstractAppropriate contraception and preconception counseling are critical for women of reproductive age with systemic autoimmune diseases since clinical diagnosis, rheumatology medications, and disease activity may impact the safety or efficacy of certain contraceptives as well as the risk of adverse pregnancy outcomes. The presence of antiphospholipid antibodies (anticardiolipin, anti-β2 Glycoprotein I and lupus anticoagulant) is the most important determinant of con...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research
Antiphospholipid syndrome (APS) is as an autoimmune disease characterized by thrombosis and/or specific pregnancy-related morbidity associated with persistent antiphospholipid antibodies, namely, lupus anticoagulant and IgG and IgM antibodies to cardiolipin and beta2 glycoprotein I. Optimal antibody detection plays a central role in diagnosis and classification. This review discusses antiphospholipid antibodies helpful for diagnosing APS. It includes the criteria and noncriteria antiphospholipid antibodies, methods for their detection, and challenges for clinical reporting and interpretation. The significance of using spec...
Source: Clinics in Laboratory Medicine - Category: Laboratory Medicine Authors: Source Type: research
Publication date: Available online 11 September 2019Source: Best Practice &Research Clinical Endocrinology &MetabolismAuthor(s): Angela Tincani, Cecilia Nalli, Jamilya Khizroeva, Victoria Bitsadze, Andrea Lojacono, Laura Andreoli, Yehuda Shoenfeld, Alexander MakatsariyaAbstractPregnancy in autoimmune diseases remains an argument of debate. In last years great improvements were done and with the correct medical support women with disease such as Systemic Lupus Erythematosus or Antiphospholipid Syndrome can afford a pregnancy and have healthy babies. The starting point is a good counselling. Women should be informed ...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - Category: Endocrinology Source Type: research
Antiphospholipid syndrome (APS) is an autoimmune disease characterised by the presence of antiphospholipid antibodies (aPL). The antibodies currently included in the classification criteria include lupus anticoagulant (LA), anticardiolipin antibodies (aCL) and anti-^2-glycoprotein 1 antibodies (^2GPI). APS can present with a variety of clinical phenotypes, including thrombosis in the veins, arteries and microvasculature and obstetrical complications. Pregnancy complications in obstetric APS (OAPS) include unexplained recurrent early pregnancy loss, fetal death, or premature birth due to severe preeclampsia, eclampsia, intr...
Source: Thrombosis Research - Category: Hematology Authors: Tags: Review Article Source Type: research
AbstractSystemic lupus erythematosus (SLE) is a chronic, autoimmune disease associated with major obstetrical complications such as gestational loss, preterm delivery, fetal growth restriction (FGR) and preeclampsia. Published literature is not consensual regarding the main risk factors for each of these outcomes. Our goal with this study was to determine the most important predictors for each of the main adverse pregnancy outcomes in this population. We conducted a retrospective cohort study of unifetal pregnancies of women with the diagnosis of SLE followed in our unit between January 1994 and December 2016. We excluded ...
Source: Clinical Reviews in Allergy and Immunology - Category: Allergy & Immunology Source Type: research
CONCLUSION: Thrombophilias are inherited or acquired predispositions to vascular thrombosis and have been associated with thrombosis of the arteriovenous fistula. Patients on hemodialysis with recurrent vascular access thrombosis and presence of thrombophilia should be evaluated about the need for anticoagulant therapy with a vitamin K antagonist. PMID: 31419276 [PubMed - as supplied by publisher]
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research
Abstract Type I Interferon gene expression has been shown to play an important role in the pathogenesis of several systemic autoimmune disorders, paving the way for its potential use as a surrogate marker or a therapeutic tool. While the concept of type I interferon signature and its correlation with clinical phenotypes and disease activity, along with anti-interferon targeted therapy have been vastly investigated in patients with systemic lupus erythematosus, there is a paucity of data concerning antiphospholipid syndrome patients. In this review, we summarize the current knowledge on the pathogenetic and clinica...
Source: Journal of Autoimmunity - Category: Allergy & Immunology Authors: Tags: J Autoimmun Source Type: research
Abstract Antiphospholipid syndrome an autoimmune disease characterized by thrombosis and/or pregnancy morbidity alongside the presence of antiphospholipid antibodies (aPL). This review evaluates primary and secondary thromboprophylaxis in patients with aPL and thrombotic events. In primary thromboprophylaxis a risk-stratified approach is needed based on aPL, comorbidity with other autoimmune conditions and cardiovascular vascular risk factors. In primary thromboprophylaxis, the efficacy of low-dose aspirin is debatable and requires better-designed controlled studies. So far warfarin has not been shown to improve v...
Source: Lupus - Category: Rheumatology Authors: Tags: Lupus Source Type: research
Authors: Fernandes MA, Gerardi MC, Andreoli L, Tincani A Abstract Antiphospholipid syndrome (APS) is a systemic autoimmune disease which manifests as thrombotic and/or obstetric adverse events, mediated by persistent circulating antiphospholipid antibodies (aPL) detected by means of three tests: lupus anticoagulant, anticardiolipin and anti β2-glycoprotein I antibodies. It can be isolated or associated with other autoimmune rheumatic diseases. During pregnancy, patients with APS have a higher risk of obstetric complications and a higher thrombotic risk due to the pregnancy itself. Therefore, a preconception co...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
AbstractObjectivesAntiphospholipid syndrome (APS) is an autoimmune disease characterized by obstetric complications and thrombotic events associated with antiphospholipid antibodies (aPL). We aimed to compare the clinical characteristics and treatment of primary APS (PAPS) and secondary APS (systemic lupus erythematosus-APS, SAPS) patients and investigate risk factors associated with obstetric complications in Shanghai, China.MethodsWe retrospectively collected and analyzed the data of obstetric APS (OAPS) patients from 2000 to 2017 in the APS-Shanghai (APS-SH) database.ResultsOne hundred eighty OAPS patients with a total ...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
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