Talk:Antiphospholipid syndrome

Rename article

The suggestion is made in this article that the anti phospholipid syndrome is caused by auto antibodies directed against negatively charged phospholipids on the cell/platelet surface. However for almost 15 years it is known that most of the antibodies in this syndrome are directed against proteins that bind negatively charged phospholipids such as prothrombin and beta-2-glycoprotein-1. It is the binding of antibodies to coagulation proteins that causes altered coagulation processes not the binding of antibodies against negatively charged phospholipids.

I suggest to change the article to correct this misunderstanding. Bio2mancer 24 june 2006.

{{sofixit}} JFW | T@lk 20:58, 4 July 2006 (UTC)

Sapporo criteria

We should mention the Sapporo criteria: PMID 10403256 . JFW | T@lk 20:58, 4 July 2006 (UTC)

And a recent amendment: PMID 16420554 . JFW | T@lk 20:59, 4 July 2006 (UTC)

Recent review

A recent systematic review on the treatment shows how little we actually know about optimal treatment for this: PMID 16507806. JFW | T@lk 21:01, 4 July 2006 (UTC)

Furthermore, a new study in the New England Journal of Medicine -- Kaandorp SP et al, N Engl J Med 362;17p1586–1596 shows no benefit of aspirin + LMWH over placebo -- in women with recurrent miscarriage -- and the accompanying editorial states that although inherited thrombophilia is associated with miscarriage, anticoagulants in this indication don't help. We know less than we think!

Page has massive changes

Since 07 NOV 06...actually making this page very inaccurate. Please revert back to previous revision before 07 NOV 06. Tried to get the categories back in. Hopefully I did it right.eyz 00:10, 21 November 2006 (UTC)

Typo

Changed a typo (phosphotidylserine to Phosphatidylserine). Rage italic 15:54, 30 March 2007 (UTC)

APSFA Page

Actaully that page is cited and is HONCode certifed. Very few sites can say that. It has a bio. upon request.eyz 17:53, 20 May 2007 (UTC)

APSCORE

APSCORE is no longer functioning due to lack of funding from the CDC and NIH. Link Removed. eyz

Nature of antibodies

Some antibodies are more aborto/thrombogenic than others PMID 17440049 JFW | T@lk 06:42, 7 August 2007 (UTC)

Blood!

doi:10.1182/blood-2007-12-129627 - how we diagnose APS. JFW | T@lk 17:29, 1 February 2009 (UTC)

Source

Is House MD a reliable and authentic source? — Preceding unsigned comment added by 93.208.112.205 (talk) 20:15, 21 September 2011 (UTC)

Absolutely not. House MD is entertainment, not a reliable source for anything.Wzrd1 (talk) 17:53, 3 February 2012 (UTC)

Review

doi:10.1182/blood-2012-03-378646 the relevance of anti-β2-glycoprotein I antibodies. JFW | T@lk 20:57, 12 July 2012 (UTC)

NEJM mechanisms of disease: doi:10.1056/NEJMra1112830 JFW | T@lk 16:09, 14 March 2013 (UTC)

Historical review in Br J Haem doi:10.1111/bjh.12848 JFW | T@lk 18:59, 31 March 2014 (UTC)

Laboratory technique

doi:10.1111/jth.12537 ISTH JFW | T@lk 07:17, 25 May 2014 (UTC)

Sentence

Hi. In the section under the subsubhead 2.1, Lupus anticoagulant, we currently begin the second paragraph thus: "Distinguishing a lupus antibody from a specific coagulation factor inhibitor (eg: Factor VIII)." This is not a sentence and does not make sense on its own. I'd fix it if I was sure how to without distorting the intended sense, but I'm not. (I was tempted to weld it into the next sentence but I'm not 100% certain that works - or was it like a yet another subhead perhaps??) Can someone who can see the sense of the whole thing please sort it out? Thanks and best wishes, DBaK (talk) 11:21, 20 November 2009 (UTC)

Fixed, though it's likely the whole section (and many others) should be drastically cut back; encyclopedias don't normally, and shouldn't, give specific diagnostic criteria and protocols - especially when these vary from place to place. Grothmag (talk) 00:13, 9 February 2016 (UTC)

Request to create disambiguation(s)

I only recently heard of this disease, and had quite a bit of difficulty finding information about it until someone mentioned that it was called by names, including “APLS or APLA in the United States and Hughes Syndrome or Sticky Blood in the UK” (information taken from the APS Foundation of America). Given the disparity of naming for the condition, I would think it appropriate to include it on various disambiguation pages and/or redirects, as appropriate, to make this information easier to locate.

I’m not familiar enough with Wikipedia’s policies to be comfortable introducing such changes myself, but I welcome others to consider those additions. Much thanks!

jF 11:48, 3 June 2016 (UTC) — Preceding unsigned comment added by 2601:3CA:204:F860:D824:EC9F:804C:D3BF (talk)

New review

doi:10.1111/bjh.14632 JFW | T@lk 19:55, 26 March 2017 (UTC)

ISTH criteria for laboratory diagnosis: doi:10.1111/jth.13976 JFW | T@lk 21:21, 17 February 2018 (UTC)

Something about the DOACs for thromboprophylaxis. doi:10.1111/jth.14017 JFW | T@lk 21:23, 12 April 2018 (UTC)

NEJM this week doi:10.1056/NEJMra1705454 JFW | T@lk 11:33, 24 May 2018 (UTC)

"New bloody syndrome" listed at Redirects for discussion

A discussion is taking place to address the redirect New bloody syndrome. The discussion will occur at Wikipedia:Redirects for discussion/Log/2020 August 2#New bloody syndrome until a consensus is reached, and readers of this page are welcome to contribute to the discussion. Steel1943 (talk) 20:40, 2 August 2020 (UTC)

ISTH SSC

Recommendations about DOACs doi:10.1111/jth.14935 JFW | T@lk 14:20, 1 September 2020 (UTC)

Wiki Education assignment: Wikipedia for the Medical Editor

This article was the subject of a Wiki Education Foundation-supported course assignment, between 24 October 2023 and 18 November 2023. Further details are available on the course page. Student editor(s): Mhowiki (article contribs). Peer reviewers: Saquiroz.

— Assignment last updated by Saquiroz (talk) 19:35, 7 November 2023 (UTC)

Hi, I am the student who made edits as a part of my Wiki Education assignment. I made large scale changes and added much information, but you can see the plan I enacted on my sandbox. Overall, I reduced the medical jargon significantly. I used blood clots instead of thrombosis and pregnancy related complications instead of obstetric. I used this mentality while a writing and editing the entire article. I moved history section up to the top for flow and changed the Risk Factors Section to Epidemiology and the Pathogenesis section to Mechanisms. I thought this would be more representative of the information and more understandable to general public. I took information from different spots in the article and reorganized it to different sections where I thought it may belong better. For the lead section, I summarized treatment more concisely and generally and fixed an error. For the Symptoms and Signs section, I reduced jargon, expanded discussion on what blood clots may look and feel like in different parts of the body, and created subcategories for most well known manifestations and other manifestations. I also added updated knowledge from the 16th International congress on antiphospholipid antibodies task force report on clinical presentation. I also changed organizational layout and introduced nuance approach to diagnosis section. I removed the specific Sydney research criteria and instead summarized them while adding the updated research criteria from 2023 join ACR/EULAR statement. I added subheaders to this section that I thought would make navigating this easier such as criteria, lab testing, and false tests. I expanded the false test section based on the ISTH guidelines released. I did not just mention false positives because they mentioned that false negatives could also happen. For the treatment section, I updated it with recent evidence and articles (including one previously mentioned on talk page) for DOACs vs Vit K antagonists. I also expanded the discussion about treatment options based on international guidelines. I tried to not go into the weeds but also give enough context to show that treatment differs based on clinical context. I left in the INR ratios because the general public could find this useful and it was mentioned in the guidelines. I also expanded the prognosis section to talk about prognostic factors and other associated risks with APS. It previously was one sentence with an uncited statistic, which I removed. In terms of sources, I only used meta-analysis, systematic reviews, and international guidelines information based in those type of studies.

Future changes needed:

-Generally: more information about CAPS could be added to all sections

-Mechanism section needs refining, updating, and reduction of jargon. I am not sure how much depth into the clotting cascade is necessary for the general public's understanding. Also, a good amount of the data in this section is from primary sources or narrative reviews. Finding secondary more reliable sources would be beneficial. I did not read these yet, but found two systematic reviews that may be helpful:

Zhu, Rui; Cheng, Chun-Yan; Yang, Yan; Denas, Gentian; Pengo, Vittorio (2022-06). "Prevalence of aPhosphatidylserine/prothrombin antibodies and association with antiphospholipid antibody profiles in patients with antiphospholipid syndrome: A systematic review and meta-analysis". Thrombosis Research. 214: 106–114. doi:10.1016/j.thromres.2022.04.021.

Tang, Kuo-Tung; Chen, Hsin-Hua; Chen, Tzu-Ting; Bracci, Nicole R.; Lin, Chi-Chien (2021-08-09). "Dendritic Cells and Antiphospholipid Syndrome: An Updated Systematic Review". Life. 11 (8): 801. doi:10.3390/life11080801.

-Symptoms and signs: Articles to add. First three are on specific noncriteria manifestations and the last one is on other autoimmune disease associated with APS.

Domingues V, Chock YP, Risse J, et al. Increased risk of acute and chronic renal lesions associated with antiphospholipid antibodies in patients with systemic lupus erythematosus: a systematic review and meta-analysis. Autoimmun Rev 2022; 21:103158.

Loiseau P, Foret T, DeFilippis EM, et al. Risk of livedo reticularis with antiphospholipid antibodies in patients with systemic lupus erythematosus: a systematic review and meta-analysis. Lupus 2022; 31: 1595–605.

Bernardoff, Inès; Picq, Alexandre; Loiseau, Pierre; Foret, Thomas; Dufrost, Virginie; Moulinet, Thomas; Unlu, Ozan; Erkan, Doruk; Wahl, Denis; Zuily, Stéphane (2022-01). "Antiphospholipid antibodies and the risk of autoimmune hemolytic anemia in patients with systemic lupus erythematosus: A systematic review and meta-analysis". Autoimmunity Reviews. 21 (1): 102913. doi:10.1016/j.autrev.2021.102913

Bernardoff, Inès; Picq, Alexandre; Loiseau, Pierre; Foret, Thomas; Dufrost, Virginie; Moulinet, Thomas; Unlu, Ozan; Erkan, Doruk; Wahl, Denis; Zuily, Stéphane (2022-01). "Antiphospholipid antibodies and the risk of autoimmune hemolytic anemia in patients with systemic lupus erythematosus: A systematic review and meta-analysis". Autoimmunity Reviews. 21 (1): 102913. doi:10.1016/j.autrev.2021.102913

El Hasbani, Georges; Viola, Mario; Sciascia, Savino; Taher, Ali T.; Uthman, Imad (2021-03). "Antiphospholipid Antibodies in Inflammatory and Autoimmune Rheumatic and Musculoskeletal Diseases Beyond Lupus: A Systematic Review of the Available Evidence". Rheumatology and Therapy. 8 (1): 81–94. doi:10.1007/s40744-020-00273-w

-Evaluation of sources: There are a few narrative reviews, primary literature, and websites being used currently. I did not remove them because I made many large scale edits and thought this would be a good task for next editor.

-Treatment: Data is needed for plasmapheresis intervention. Also, look out for more data on IVIG. I read this in my lit review and international guidelines that it can be sometimes used, but there is still not enough evidence to support it widely.

-Diagnosis: I think this section can still improve especially in the testing section. I think it needs to be simplified and fact checked. The SSC and ISTH guidelines may be helpful but I was struggling to understand it. Also, I was not sure if I needed to include references for the differential section. I added what I knew and wikilinked the pages, but if others think references would be important please add them. Earlier this section just had genetic thrombophilia so I wanted to expand it and show that that isn't the only diagnoses to consider and it may differ based on presenting symptoms.

Research: Information needs to be fact checked. I could not find that organization in that article, so that information may need to be removed.

Please reach out to my wiki page or comment below if you have any questions or concerns

Mhowiki (talk) 16:29, 15 November 2023 (UTC)

I ended up removing the following from the research section because I could not find the information in the citation "APS ACTION (the AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking), is the first-ever international research network that has been created to design and conduct large-scale, multicenter clinical trials in persistently antiphospholipid antibody (aPL) positive patients.[1] The network consists of a multidisciplinary group of physicians and investigators from around the world who are interested in antiphospholipid syndrome (APS) research. The primary mission of APS ACTION is to prevent, treat, and cure antiphospholipid antibody (aPL) associated clinical manifestations through high quality, multicenter, and multidisciplinary clinical research. [citation needed]". It had been cited with this citation: Erkan D, Derksen R, Levy R, Machin S, Ortel T, Pierangeli S, et al. (February 2011). "Antiphospholipid Syndrome Clinical Research Task Force report". Lupus. 20 (2): 219–224. doi:10.1177/0961203310395053.

Mhowiki (talk) 19:52, 17 November 2023 (UTC)