Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_35_библиотеки_им_акад_М_И_Перельмана

autoimmune (AI) disease characterized by the presence of antiphospholipid antibodies in serum, mainly lupus antico­agulant, anticardiolipin antibodies, and anti-B2 glycoprotein antibodies. These antibodies are purported to affect multiple components of coagulation pathway including protein C, platelets, brinolysis, annexin V, and blood vessels [46]. APS exists either in isolation (primary APS) or in association with preexisting AI conditions like systemic lupus erythema­tosus (SLE) (secondary APS) [47]. A separate and often life­threatening form termed catastrophic APS (CAPS) is associated with thrombotic microangiopathy and multiple organ thromboses. APS is diagnosed by the presence of auto­antibodies and at least one clinical feature (i.e., vascular thrombosis, recurrent fetal loss, etc.) [48]. Deep vein throm­bosis (DVT) and cerebral vascular events predominate most presentations of APS, although cardiac valve disease and coronary atherosclerosis can manifest as well [47, 49–51]. In terms of coagulation defects, 20% of patients are also at risk for a mild-moderate thrombocytopenia [48]. This is postu­lated to result from increased platelet destruction by APS antibodies; therefore platelet supplementation does not reduce the risk of bleeding [52].