Keywords
capillaroscopy
antiphospholipid antibodies
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Abstract
Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by arterial and/or venous thrombosis and high levels of antiphospholipid antibodies (aPL). The disease mainly affects women over 30 years of age and can occur as a primary syndrome (PAPS) or in the context of another autoimmune disease (secondary APS). Antiphospholipid antibodies (aPL) can cause blood clots to form in the veins and arteries and lead to heart attack, stroke, pulmonary embolism, preeclampsia, miscarriage, slow growth or damage to the fetus, premature / stillbirth. Risk factors include arterial hypertension, obesity, hypercholesterolemia and hypertriglyceridemia, smoking, atherosclerosis, taking birth control pills or associated autoimmune diseases (such as systemic lupus, SLE). In patients with PAPS, capillary hemorrhages are associated with neurological manifestations and with comorbidity (most often with hypertension). In some people, the syndrome is asymptomatic, while in others the disease may present with deep vein thrombosis, bleeding from the nose and gums, unusually heavy menstruation, hematemesis, melena. Complications include pulmonary embolism, stroke, heart attack or transient ischemic attack in young people without risk factors for cardiovascular disease, kidney failure, miscarriages, etc. Treatment aims to reduce the risk of blood clots through anticoagulant therapy. Raynaud's phenomenon (RP) represents the most common clinical aspect of microvascular involvement and is a key feature of diseases such as systemic sclerosis (SSc), mixed connective tissue disease (MCTD), systemic lupus erythematosus (SLE), dermatomyositis (DM), polymyositis (PM) and antiphospholipid syndrome (APS). Nail bed capillaroscopy (NVC) is an extremely useful, noninvasive, and reliable method for analyzing microvascular changes in Raynaud's phenomenon and systemic diseases, as well as for determining disease severity and prognosis. The presence of autoantibodies or capillaroscopic changes are essential for the early diagnosis of APS. It is not well established whether...
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