Do you typically screen patients for antiphospholipid antibodies in autoimmune diseases besides lupus in the absence of a clotting event?
Answer from: at Community Practice
I would check antiphospholipid antibodies (APLAs) in a few situations in the absence of thrombotic events: 1. In someone with other APS manifestations:
Obstetrical complications (especially)
APL nephropathy noted on renal bx
Unexplained adrenal hemorrhage/microthrombosis
Non-infectious endo...
I check APLs in all women who are planning to conceive or see me while pregnant and who have a rheumatic disease. Positivity is up to 20% in other diseases. It is difficult to tell if these are pathologic or not in non-SLE diagnoses, but seeing that APS can exist as a diagnosis on its own without a ...
I do not routinely screen for the presence of APL in all non-lupus RMD without clinical signs of APLS. My rationale is that detecting APL in these patients would not typically change the management of these individuals.There is evidence suggesting a high prevalence of APL antibodies in systemic scle...
Comments
at Uniformed Services University of the Health Sciences (USUHS) Dr. @Broder, thanks for mentioning the estrogen OC...
In the absence of a clotting disorder, the presence of these antibodies is not going to change my management of the patient, but it can produce a lot of anxiety in the patient. I get many referrals of patients with positive APS antibodies that were checked for unknown reasons during the annual physi...
Drs. @Rodriguez-Pla, @Sigal, and others; one reason is that we now have new EULAR/ACR APS guidelines which help to point out the need to consider APS in non-thrombotic situations. OB complications are the most evident but there are other places where we do not want to miss. It is a great educational...
Big no. Any result gives you no clinical insight and no advance in diagnosis and nothing to treat. Meanwhile you notify someone of a serologic finding of no known clinical significance so they can use the internet to find something to worry about. So, no
Comments
at University of Chicago The majority of women with rheumatic diseases are ...
at UTMB Health Generally, I do not recommend estrogens in patient...
at University of Chicago Dr. @Gonzalez. The ACR has evidence-based recommen...
at UTMB Health Yes, thank you. That is what I basically said abov...
at University of Chicago Dr. @Gonzalez, let's not discredit the work of our...
at UTMB Health Generally, outside legitimate OB-GYN indications, ...