Antiphospholipid antibodies and multiple organ failure in critically ill cancer patients
Main Author: | |
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Publication Date: | 2009 |
Other Authors: | , |
Format: | Article |
Language: | eng |
Source: | Clinics |
Download full: | https://www.revistas.usp.br/clinics/article/view/17973 |
Summary: | OBJECTIVES: To describe the clinical outcomes and thrombotic events in a series of critically ill cancer patients positive for antiphospholipid (aPL) antibodies. DESIGN: Retrospective case series study. SETTING: Medical-surgical oncologic intensive care unit (ICU). PATIENTS AND PARTICIPANTS: Eighteen patients with SIRS/sepsis and multiple organ failure (MOF) and positive for aPL antibodies, included over a 10-month period. INTERVENTIONS: None MEASUREMENTS AND RESULTS: aPL antibodies and coagulation parameters were measured up to 48 hours after the occurrence of acrocyanosis or arterial/venous thrombotic events. When current criteria for the diagnosis of aPL syndrome were applied, 16 patients met the criteria for "probable" and two patients had a definite diagnosis of APL syndrome in its catastrophic form (CAPS). Acrocyanosis, arterial events and venous thrombosis were present in eighteen, nine and five patients, respectively. Sepsis, cancer and major surgery were the main precipitating factors. All patients developed MOF during the ICU stay, with a hospital mortality rate of 72% (13/18). Five patients were discharged from the hospital. There were three survivors at 90 days of follow-up. New measurements of lupus anticoagulant (LAC) antibodies were performed in these three survivors and one patient still tested positive for these antibodies. CONCLUSIONS: In this small series of patients, we observed a high frequency of auto-antibodies and micro- and macro-vascular thrombotic events in critically ill cancer patients. The coexistence of sepsis or SIRS and aPL antibodies was often associated with MOF and death. More studies are necessary to determine the pathophysiological significance of antiphospholipid antibodies in severely ill cancer patients. |
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Antiphospholipid antibodies and multiple organ failure in critically ill cancer patients Antiphospholipid syndromeMultiple organ failureCancerThrombosisSepsisLupus anticoagulant OBJECTIVES: To describe the clinical outcomes and thrombotic events in a series of critically ill cancer patients positive for antiphospholipid (aPL) antibodies. DESIGN: Retrospective case series study. SETTING: Medical-surgical oncologic intensive care unit (ICU). PATIENTS AND PARTICIPANTS: Eighteen patients with SIRS/sepsis and multiple organ failure (MOF) and positive for aPL antibodies, included over a 10-month period. INTERVENTIONS: None MEASUREMENTS AND RESULTS: aPL antibodies and coagulation parameters were measured up to 48 hours after the occurrence of acrocyanosis or arterial/venous thrombotic events. When current criteria for the diagnosis of aPL syndrome were applied, 16 patients met the criteria for "probable" and two patients had a definite diagnosis of APL syndrome in its catastrophic form (CAPS). Acrocyanosis, arterial events and venous thrombosis were present in eighteen, nine and five patients, respectively. Sepsis, cancer and major surgery were the main precipitating factors. All patients developed MOF during the ICU stay, with a hospital mortality rate of 72% (13/18). Five patients were discharged from the hospital. There were three survivors at 90 days of follow-up. New measurements of lupus anticoagulant (LAC) antibodies were performed in these three survivors and one patient still tested positive for these antibodies. CONCLUSIONS: In this small series of patients, we observed a high frequency of auto-antibodies and micro- and macro-vascular thrombotic events in critically ill cancer patients. The coexistence of sepsis or SIRS and aPL antibodies was often associated with MOF and death. More studies are necessary to determine the pathophysiological significance of antiphospholipid antibodies in severely ill cancer patients. Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2009-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/1797310.1590/S1807-59322009000200003Clinics; Vol. 64 No. 2 (2009); 79-82 Clinics; v. 64 n. 2 (2009); 79-82 Clinics; Vol. 64 Núm. 2 (2009); 79-82 1980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/17973/20038Salluh, Jorge I. F.Soares, MárcioMeis, Ernesto Deinfo:eu-repo/semantics/openAccess2012-05-22T18:49:10Zoai:revistas.usp.br:article/17973Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2012-05-22T18:49:10Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Antiphospholipid antibodies and multiple organ failure in critically ill cancer patients |
title |
Antiphospholipid antibodies and multiple organ failure in critically ill cancer patients |
spellingShingle |
Antiphospholipid antibodies and multiple organ failure in critically ill cancer patients Salluh, Jorge I. F. Antiphospholipid syndrome Multiple organ failure Cancer Thrombosis Sepsis Lupus anticoagulant |
title_short |
Antiphospholipid antibodies and multiple organ failure in critically ill cancer patients |
title_full |
Antiphospholipid antibodies and multiple organ failure in critically ill cancer patients |
title_fullStr |
Antiphospholipid antibodies and multiple organ failure in critically ill cancer patients |
title_full_unstemmed |
Antiphospholipid antibodies and multiple organ failure in critically ill cancer patients |
title_sort |
Antiphospholipid antibodies and multiple organ failure in critically ill cancer patients |
author |
Salluh, Jorge I. F. |
author_facet |
Salluh, Jorge I. F. Soares, Márcio Meis, Ernesto De |
author_role |
author |
author2 |
Soares, Márcio Meis, Ernesto De |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Salluh, Jorge I. F. Soares, Márcio Meis, Ernesto De |
dc.subject.por.fl_str_mv |
Antiphospholipid syndrome Multiple organ failure Cancer Thrombosis Sepsis Lupus anticoagulant |
topic |
Antiphospholipid syndrome Multiple organ failure Cancer Thrombosis Sepsis Lupus anticoagulant |
description |
OBJECTIVES: To describe the clinical outcomes and thrombotic events in a series of critically ill cancer patients positive for antiphospholipid (aPL) antibodies. DESIGN: Retrospective case series study. SETTING: Medical-surgical oncologic intensive care unit (ICU). PATIENTS AND PARTICIPANTS: Eighteen patients with SIRS/sepsis and multiple organ failure (MOF) and positive for aPL antibodies, included over a 10-month period. INTERVENTIONS: None MEASUREMENTS AND RESULTS: aPL antibodies and coagulation parameters were measured up to 48 hours after the occurrence of acrocyanosis or arterial/venous thrombotic events. When current criteria for the diagnosis of aPL syndrome were applied, 16 patients met the criteria for "probable" and two patients had a definite diagnosis of APL syndrome in its catastrophic form (CAPS). Acrocyanosis, arterial events and venous thrombosis were present in eighteen, nine and five patients, respectively. Sepsis, cancer and major surgery were the main precipitating factors. All patients developed MOF during the ICU stay, with a hospital mortality rate of 72% (13/18). Five patients were discharged from the hospital. There were three survivors at 90 days of follow-up. New measurements of lupus anticoagulant (LAC) antibodies were performed in these three survivors and one patient still tested positive for these antibodies. CONCLUSIONS: In this small series of patients, we observed a high frequency of auto-antibodies and micro- and macro-vascular thrombotic events in critically ill cancer patients. The coexistence of sepsis or SIRS and aPL antibodies was often associated with MOF and death. More studies are necessary to determine the pathophysiological significance of antiphospholipid antibodies in severely ill cancer patients. |
publishDate |
2009 |
dc.date.none.fl_str_mv |
2009-02-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/17973 10.1590/S1807-59322009000200003 |
url |
https://www.revistas.usp.br/clinics/article/view/17973 |
identifier_str_mv |
10.1590/S1807-59322009000200003 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/17973/20038 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 64 No. 2 (2009); 79-82 Clinics; v. 64 n. 2 (2009); 79-82 Clinics; Vol. 64 Núm. 2 (2009); 79-82 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222754396438529 |