61. PRIMARY ANTIPHOSPHOLIPID SYNDROME PRESENTING AS BUDD-CHIARI SYNDROME PRIMARY antiphospholipid syndrome PRESENTING. AS BUDDCHIARI SYNDROME.Mahgoub B. Ibrahim, MBBS, FRCP; Abdulhalim J. Kinsara, MD, JBIM. http://www.kfshrc.edu.sa/annals/182/97-121.html

PRIMARY ANTIPHOSPHOLIPID SYNDROME PRESENTING AS BUDD-CHIARI SYNDROME Mahgoub B. Ibrahim, MBBS, FRCP; Abdulhalim J. Kinsara, MD, JBIM We report the case of a young Saudi male who presented with Budd-Chiari syndrome (BCS), with not only hepatic vein thrombosis but also an extensive thrombosis of the inferior vena cava (IVC) and portal vein, associated with anticardiolipin antibodies (antiphospholipid syndrome). No other thrombogenic condition was present as an alternative explanation for the highly unusual site of the venous thrombosis. The patient was managed with prolonged anticoagulation and recovered successfully. The association of antiphospholipids with BCS is well recognized in the literature, but to the best of our knowledge this is the first case to be reported in the Middle East. Case Report A 30-year-old Saudi soldier presented to our hospital with a seven-month history of abdominal pain and progressive abdominal distention associated with mild jaundice. He had no history of gastrointestinal bleeding. He denied any history of blood transfusion, taking medications or alcohol abuse. Physical examination showed an ill-looking man who was generally wasted and jaundiced. Abdominal examination showed distended veins over his abdomen and back, extending up to the thoracic wall, with an upward direction of the flow. There was hepatomegaly and moderate ascites. The rest of the examination was non-contributory.

62. Lupus Anticoagulant/Antiphospholipid Syndrome Lupus Anticoagulant/antiphospholipid syndrome Patients with lupusanticoagulants have a tendency to thrombose. Laboratory assays http://www.medicine.uiowa.edu/Path_Handbook/Appendix/Heme/lupus.html

Lupus Anticoagulant/Antiphospholipid Syndrome See the Algorithm for long aPTT or PT on the next page. Other tests are performed reflexively in the laboratory to evaluate a prolonged aPTT. This testing is triaged through the Hemostasis/Thrombosis Laboratory. Please call the lab (319/356-3573) for further information.

63. Nature Publishing Group 12 March 1998. Nature 392, 193 197 (1998). A lipid associated with theantiphospholipid syndrome regulates endosome structure and function http://www.nature.com/cgi-taf/DynaPage.taf?file=/nature/journal/v392/n6672/full/

64. Nature Publishing Group 12 March 1998. Nature 392, 193 197 (1998). A lipid associated with theantiphospholipid syndrome regulates endosome structure and function. http://www.nature.com/cgi-taf/DynaPage.taf?file=/nature/journal/v392/n6672/abs/3

65. BioMed Central Abstract Trial Report - Antiphospholipid Trial Report Trial Report antiphospholipid syndrome Joan T Merrill MD Current RheumatologyReports 2002 4377-378 (published 1 October 2002) First paragraph http://www.biomedcentral.com/1523-3774/4/377/abstract

66. BioMed Central Abstract Lupus Vasculitis Differential Report Lupus Vasculitis Differential Diagnosis with antiphospholipid syndrome TheoDov Golan MD Division of Clinical Immunology, POB 4940, Bnai Zion Medical http://www.biomedcentral.com/1523-3774/4/18/abstract

67. 26b. Antiphospholipid Syndrome 26b. antiphospholipid syndrome. The ulcer healed with the intralesional injectionof corticosteroids, after treatment with stanozolol had failed. http://www.bu.edu/woundbiotech/wounds/UncommonWounds Gallery/pages/26b..htm

Woundbiotech: Uncommon Wounds Antiphospholipid syndrome. The ulcer healed with the intralesional injection of corticosteroids, after treatment with stanozolol had failed. Dr. Falanga

68. 26a. Antiphospholipid Syndrome Woundbiotech Uncommon Wounds. 26a. antiphospholipid syndrome. Thiswoman with lupus erythematosus had a persistent ulcer. She had http://www.bu.edu/woundbiotech/wounds/UncommonWounds Gallery/pages/26a..htm

Woundbiotech: Uncommon Wounds Antiphospholipid syndrome. This woman with lupus erythematosus had a persistent ulcer. She had a history of recurrent thrombotic episodes and spontaneous abortions. Note the subtle lacy pattern of microlivedo around the ulcer. Dr. Falanga

69. High-Risk Pregnancy - Antiphospholipid Syndrome (aPL) HighRisk Pregnancy antiphospholipid syndrome (aPL). What is antiphospholipidsyndrome (aPL)? How does pregnancy affect antiphospholipid syndrome (aPL)? http://www.musckids.com/health_library/hrpregnant/autoapl.htm

Home About Us Departments MUSC eNurse ... Your Hospital Visit 171 Ashley Ave. Charleston, SC 29425 800-424-MUSC Print Version High-Risk Pregnancy Antiphospholipid Syndrome (aPL) What is antiphospholipid syndrome (aPL)? Antiphospholipid syndrome is an autoimmune disease in which the body produces large amounts of antiphospholipid antibodies. Phospholipids are a special type of fat containing phosphate that makes up the outer walls of the body's cells. Antiphospholipid antibodies attack the phospholipids. This causes many different problems including increased blood clotting. Cardiolipin is one type of phospholipid and specific anticardiolipin antibodies may develop. This disease is about two times more common in women than men. It is generally characterized by the following: thrombosis - blood clots in arteries or veins (especially in the legs). Clots in vessels of the central nervous system (brain and spinal cord) can result in stroke. thrombocytopenia - low platelets (cells important in blood clotting). pregnancy loss (especially repeated losses) Antiphospholipid syndrome was only defined in recent years and is sometimes called Hughes syndrome, or sticky blood syndrome. The disease may occur along with other autoimmune diseases such as systemic lupus erythematosus (SLE, or lupus).

70. Antiphospholipid Syndrome Nephropathy antiphospholipid syndrome NEPHROPATHY. Dominique Nochy 1 , Eric Daugas1 , Gary Hill 1 , JeanPierre Grunfeld 2 1 Service d’Anatomie http://www.sin-italia.org/jnonline/forum/aps/apscases.htm

ANTIPHOSPHOLIPID SYNDROME NEPHROPATHY Dominique Nochy , Eric Daugas , Gary Hill , Jean-Pierre Grunfeld : Service de Néphrologie, Hôpital Necker, Paris, France corresponding author : Pr. Jean-Pierre GRÜNFELD, Service de Néphrologie, Hôpital Necker, rue de Sèvres, F-75015 Paris, France; e-mail : jean-pierre.grunfeld@nck.ap-hop-paris.fr; phone: +33144495412. Case : A 33-year-old male was admitted to our department of Vascular Medecine in October 1993 because of necrotic leg ulcers recurring over a three year period. These painful ulcers were associated with typical pigmented and atrophic scars of livedoid vasculitis or "atrophie blanche". The pedal pulses were positive. He presented a Raynaud 's phenomenon of the four extremities developing in childhood, and systemic hypertension for 10 years. There was no history of diabetes; discoid rash and Systemic Lupus Erythematosus (SLE) or "lupus like-disease" were excluded according to the ARA criteria and because of the absence of elevated dsDNA or ENA antibodies. Fig 1 Clinical examination demonstrated a silent nasal septum perforation which was biopsied, and mitral valve disease with a mitral systolic murmur.

71. OVERVIEW OF THE RENAL PATHOLOGY OF ANTIPHOSPHOLIPID SYNDROME OVERVIEW OF THE RENAL PATHOLOGY OF antiphospholipid syndrome. DominiqueNOCHY Primary antiphospholipid syndrome. The antiphospholipid http://www.sin-italia.org/jnonline/forum/aps/overview2.htm

OVERVIEW OF THE RENAL PATHOLOGY OF ANTIPHOSPHOLIPID SYNDROME Primary antiphospholipid syndrome The antiphospholipid syndrome (APS) is defined by widespread arterial and venous thrombosis, recurrent fetal losses, associated with antibodies directed against phospholipids (aCL and/or LA) . This is a chronic vasoocclusive disease with acute thrombotic episodes which may involve the arteries and veins at any level of the vascular tree. Initially and historically it has been linked to SLE but APS has been described in a large variety of conditions, during other connective tissue diseases, pregnancy, dialysis, transplantation or other acute and chronic nephropathies , and in the absence of all these conditions, leading to the concept of "primary" APS, proposed by Asherson , and Font and Cervera . Briefly, the majority of visceral manifestations in the course of APS outside of the kidney (skin, brain , lungs, heart, eyes) were well recognized and described, whereas the renal manifestations were essentially absent from the literature . In 1994, Piette et al

72. Mycoplasma Penetrans And Primary Antiphospholipid Syndrome Mycoplasma penetrans Bacteremia and Primary antiphospholipid syndrome (1). References. Hughes GRV. The antiphospholipid syndrome ten years on. http://www.cfsresearch.org/mycoplasma/publications/linkschronic/2nf.htm

Mycoplasma penetrans Bacteremia and Primary Antiphospholipid Syndrome PDF Download Mycoplasma penetrans , a rare bacterium so far only found in HIV-infected persons, was isolated in the blood and throat of a non-HIV-infected patient with primary antiphospholipid syndrome (whose etiology and pathogenesis are unknown). Antiphospholipid syndrome (APS), first described in 1983 to 1986, is characterized by a wide variety of hemocytopenic and vaso-occlusive manifestations and is associated with antibodies directed against negatively charged phospholipids. Features of APS include hemolytic anemia, thrombocytopenia, venous and arterial occlusions, livedo reticularis, pulmonary manifestations, recurrent fetal loss, neurologic manifestations (stroke, transverse myelitis, Guillain-Barré syndrome); and a positive Coombs test, anticardiolipin antibodies, or lupus anticoagulant activity ( ). The factor(s) causing production of the antiphospholipid antibodies in primary antiphospholipid syndrome (PAPS) remain unidentified ( A substantial number of patients with Mycoplasma pneumoniae ). Furthermore, many clinical criteria for APS have also been well documented in patients with

73. Antiphospholipid Syndrome Return to Coronet Books main page. antiphospholipid syndrome By J. Arnout1994 (Leuven University Press) ISBN 906186-635-9 109 p. $47.50 Paper. http://www.coronetbooks.com/books/anti6359.html

Return to Coronet Books main page Antiphospholipid Syndrome By J. Arnout 1994 (Leuven University Press) ISBN: 90-6186-635-9 109 p. $47.50 Paper Medical Sciences

74. Florida State University College Of Medicine Digital Library antiphospholipid syndrome Clinical Resources. antiphospholipid syndrome Accessdocument; Antiphospholipid Antibody Syndrome and Pregnancy Access document; http://fsumed-dl.slis.ua.edu/clinical/immunology/autoimmune/antiphospholipid-syn

Clinical Resources by Topic: Immunology Antiphospholipid Syndrome Clinical Resources Emergency Pediatrics Geriatrics Pathology ... Miscellaneous Resources See also: General Immunology Clinical Resources Antiphospholipid Syndrome Patient/Family Resources Harrison's Principles of Internal Medicine 15th Ed.-2001: Table of contents Medical Library subscription INFO Chapter 307: Autoimmunity and Autoimmune Diseases: Table of contents Introduction: Access document Mechanisms of Autoimmunity Access document Genetics: Access document Immunopathogenic Mechanisms in Autoimmune Diseases: Access document Autoimmune Disease: Access document Introduction: Access document Organ-Specific versus Systemic Autoimmune Diseases: Access document Systemic Autoimmune Disease Access document Chapter 275: Glomerulopathies Associated with Multisystem Diseases: Table of contents Introduction: Access document Immunologically Mediated Multisystem Diseases: Access document Introduction: Access document Antiphospholipid Antibody Syndrome and Thrombotic Microangiopathy: Access document Ruddy: Kelly's Textbook of Rheumatology 6th Ed.-2001 (MD Consult):

75. Florida State University College Of Medicine Digital Library antiphospholipid syndrome Patient/Family Resources. Miscellaneous. Miscellaneousantiphospholipid syndrome Patient/Family Resources Healthfinder Homepage http://fsumed-dl.slis.ua.edu/patientinfo/immunology/autoimmune/antiphospholipid-

Patient/Family Resources by Topic: Immunology Antiphospholipid Syndrome Patient/Family Resources Miscellaneous See also: General Immunology Patient/Family Resources Antiphospholipid Syndrome Clinical Resources American Autoimmune Related Diseases Association: Homepage Medical Information: List of documents Antiphospholipid Syndrome Access document InteliHealth Disease and Condition Guide Table of contents Antiphospholipid Antibody Syndrome: Access document Miscellaneous Antiphospholipid Syndrome Patient/Family Resources Healthfinder: Homepage Systemic Lupus Erythematosus: List of documents YAHOO - Health:Diseases and Conditions: Antiphospholipid Syndrome Additional Antiphospholipid Syndrome resources ( These sites have not been reviewed. YAHOO - Health:Medicine:Immunology Additional Immunology resources ( These sites have not been reviewed. Medical Library Florida State University College of Medicine Service provided by the Clinical Digital Libraries Project of the UA and UNT Schools of Library and Information Studies Powered by UA Digital Libraries Navigation Lab technology

76. Antiphospholipid Syndrome & MS The antiphospholipid syndrome and Multiple Sclerosis . Dr. Graham RVHughes, MD FRCP Head of Lupus Research Unit The Rayne Institute St. http://www.infotech.demon.co.uk/MS.htm

The Antiphospholipid Syndrome and "Multiple Sclerosis" Dr. Graham R.V. Hughes, MD FRCP Head of Lupus Research Unit The Rayne Institute St. Thomas' Hospital, London SE1 7EH (First printed in: LUPUS (1999), Volume 8 Number 2 (Full references have been omitted and the reader should refer to the above journal or to Stockton Press The issue of "Lupus" includes a further study embracing "multiple sclerosis" (MS) or "atypical MS" in the clinical spectrum covered by the antiphospholipid syndrome (APS). As IJdo et al (1998) pointed out in their paper, "with increasing utilisation of MRI studies, there has been a marked increased incidence in the misdiagnosis of MS in the American population". An observation which can probably be applied elsewhere. One of the different diagnosis of MS is APS. from the first clinical descriptions, it was obvious that neurological features were both frequent and protean. Spinal cord involvement has included Guillain-Barre syndrome and transverse myelitis. Anecdotally, most clinicians dealing with APS or lupus with APS have seen patients initally labelled as "probable MS". Certainly the ischaemic changes produced by the APS in the white matter may be indistinguishable on MRI from those of MS. Conversely, it may be that some patients with "true" MS occasionally exhibit anticardiolipin (aCL) antibodies. Fukazawa et al (1993) found that 2 out of 38 patients with definite MS had positive aCL titres. Both of these patients had optic neuritis and transverse myelitis. A subsequent study reported positive aCL (IgG 9% and IgM 44%) in 32 MS patients. Another study from Japan reviewed 20 cases of MS, all of whom had optic neuritis. No less that 9 had transverse mylelitis. Four patients (all of whom had optic neuritis and myelitis) were positive for aCL. In a small study in our department, sera from 36 MS patients were studied. Five were aPL positive and of these, two had transverse myelitis (unpublished observations).

77. Antiphospholipid Syndrome Assays Clinical Conditions antiphospholipid syndrome Assays, http://peir.path.uab.edu/coag/article_151.shtml

Front Page Announcements Contact Us Clinical Conditions ... Test Order Form Search All Categories Front Page Announcements Contact Us Clinical Conditions Guidelines Links Patient Education Test Menu Test Order Form Clinical Conditions Antiphospholipid Syndrome Assays Email this article Printer friendly page The lupus anticoagulant profile and anticardiolipin antibody IgG and IgM assays are definitive for antiphospholipid syndrome and should be ordered together whenever the syndrome is suspected. Select each for further assay information: Lupus anticoagulant profile Anticardiolipin antibody (ACA) IgG and IgM also called... Antiphospholipid antibody (APL) IgG and IgM The PT, PTT and mixing studies listed below may be useful screens for lupus anticoagulant but are not as sensitive as the lupus anticoagulant profile or the ACA. Prothrombin time (PT) with INR PT mixing study Partial thromboplastin time (PTT) PTT mixing study Lupus anticoagulant testing is a complex series of assays including the PTT-LA, Sta-Clot LA, and DRVVT assays. For further information on the testing protocol, go to Thrombophilia Guidelines Top of Page

78. Immunologic Diseases antiphospholipid syndrome About antiphospholipid syndrome E Letko Massachusetts Eye Ear Infirm. (US); Antiphospholipid Antibody http://www.mic.ki.se/Diseases/c20.html

search help staff Immunologic Diseases Patients and laypersons looking for guidance among the target sources of this collection of links are strongly advised to review the information retrieved with their professional health care provider. Alphabetical List of Diseases Search PubMed at NCBI/NLM Immonology Bowers et al. ; educ.] - Univ of South Carolina (US) A 4-pages introduction to The Immune System - Nobel Foundation About the Immune System - NCI/NIH (US) The Anatomy of the Immune System , and an Immunology Glossary - Univ of Leicester (UK) Basic Immunology G Heath ] - Optometry Today, Feb 2002 (UK) The Human Immune System K Bendtzen ] - Rigshospitalet (DK) Understanding the Immune System Schindler et al. ] - Cancer.gov (US) Immunobiology. 5th ed. Janeway et al. , 2001; online book] - via PubMed, NLM (US) The Immune System TJ Copeland An Immunology Study Sheet - Medical Study Guides, Univ of Kansas (US) How Your Immune System Works M Brain Immunobiology animations [Flash 5 Player required] - Garland Science Publ. (UK) Immunological Disorders Edgar and Sewell ; sample chapter] - Textbook of Medicine/Souhami et al.

79. Virtual Hospital: University Of Iowa Family Practice Handbook, Fourth Edition: R University of Iowa Family Practice Handbook, Fourth Edition, Chapter7. Rheumatology antiphospholipid syndrome. David C. Krupp, MD http://www.vh.org/adult/provider/familymedicine/FPHandbook/Chapter07/14-7.html

For Providers University of Iowa Family Practice Handbook, Fourth Edition, Chapter 7 Rheumatology: Antiphospholipid Syndrome David C. Krupp, MD and Mark A. Graber, MD Departments of Family Medicine and Emergency Medicine University of Iowa Hospitals and Clinics and College of Medicine Peer Review Status: Externally Peer Reviewed by Mosby General . Antiphospholipid syndrome (APS) is a disorder characterized by recurrent venous or arterial thrombosis, recurrent fetal loss, and thrombocytopenia associated with the presence of lupus anticoagulant or anticardiolipin antibody, or both. The female-to-male ratio is 2:1. May occur as a manifestation of lupus or may occur as an isolated, discrete syndrome. Anticardiolipin and antiphospholipid are essentially interchangeable terms. Depending on the assay used to detect them, they cross-react. Several subtypes that do not cross-react have been identified but are currently of little clinical significance. Clinical Features Pregnancy loss . Obstetric complications include recurrent fetal loss, often but not always in the late second or third trimester, severe pre-eclampsia, premature delivery, chorea gravidarum, and intrauterine growth retardation. Patients may also have "postpartum syndrome," which is manifested by pleuropericarditis and fever.

80.  Antiphospholipid Syndrome  Home Back Up . antiphospholipid syndrome antiphospholipid syndrome,See Phospholipid antibody syndrome . Home Back Up . http://www.rcpa.edu.au/pathman/antiphos.htm

Antiphospholipid syndrome Antiphospholipid syndrome See Phospholipid antibody syndrome

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