To Find out the Association of Antiphospholipid Antibody Syndrome and Chronic Leg Ulcers

Sheja, Arul (2012) To Find out the Association of Antiphospholipid Antibody Syndrome and Chronic Leg Ulcers. Masters thesis, PSG Institute of Medical Science and Research, Coimbatore.

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Abstract

INTRODUCTION: Antiphopspholipid antibody syndrome (APS) is characterized by the presence of antiphopspholipid antibodies (APLA), recurrent thrombosis and fetal loss. Antiphopspholipid antibodies are a family of auto antibodies that recognize various combinations of phospholipids, phospholipid-binding proteins or both. The exact pathogenic mechanism in which these antibodies cause thrombosis is not known. This syndrome is termed as primary APS when it occurs in the absence of underlying or associated disease. Secondary APS is associated with autoimmune diseases such as systemic lupus erythematosus. Clinical features can vary widely and can involve any organ system but the features for both primary and secondary APS are identical. In primary APS, dermatological manifestations are probably the most common and 40% of the patients may have cutaneous feature as the major complaint. Skin manifestations may be the first clue to this syndrome and it is important to be aware and investigate the possibility of APS when facing cutaneous findings related to venous or arterial thrombosis or microthrombosis. AIM AND OBJECTIVES: To find out the association of Antiphospholipid antibody syndrome and chronic leg ulcers. MATERIALS AND METHODS: 1. Patients with chronic leg ulcers (fail to heal within a period of 6 weeks) during the period 2010 – 2012. 2. History of all the patients will be recorded and analyzed. 3. Clinical features will be noted. 4. Specific investigations like antinuclear antibody, lupus anticoagulant, anticardiolipin antibody, rheumatoid factor, punch biopsy, doppler, VDRL will be done in all patients. INCLUSION CRITERIA: 1. Both male and females with chronic leg ulcers, 2. Patients with ulceration connected with connective tissue disorders, 3. Arterial and venous ulcers. EXCLUSION CRITERIA: 1. Acute ulcers, 2. Traumatic ulcers, 3. Neuropathic ulcers, 4. Neoplastic ulcers, 5. Ulcers due to metabolic disorders, 6. Drug induced ulcers, 7. Ulcers due to hematological disease. RESULTS: A total of 40 patients were taken up for the study. • Their age ranged from 18 years to 80 years. • 17 patients were female and the remaining 23 males. • The duration of ulcer varied between 2 months to 9 years. • 12 patients were positive once and 4 patients were positive twice. • Of the 4 patients who were twice positive one was primary APLA and 3 were Secondary APLA. • Of the 4 patients twice positive 3 were female and 1 male. • Of the 3 female patients who were twice positive one had pregnancy related complications(Intra uterine death). • Of the 4 patients who were twice positive one had reactive VDRL (1:8). • Of the 4 patients one patient doppler study showed arterial thrombus without inflammatory signs. • Of the 4 patients who were twice positive for antiphospholipid antibody syndrome 2 were positive for ANA. • Out of the 36 patients who were APLA Negative, 10 had varicose veins, 6 had Vasculitis, 3 had Pyoderma and 17 had chronic ulcer of unknown cause. • Out of the 8 Patients who were APLA positive once at the time of diagnosis, 2 had varicose veins, 1 had DVT / Varicose Veins, 3 had Vasculitis and 2 had chronic leg ulcer of unknown cause. CONCLUSION: In our study 10% of the patients with leg ulcers had antiphospholipid antibodies. These antibodies are associated with considerable mortality and morbitity and so early detection and treatment is important to prevent life threatening complications like thrombosis. Antiphospholipid antibody is important in the evaluation of patients with chronic non healing ulcer.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Association of Antiphospholipid Antibody Syndrome, Chronic Leg Ulcers.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 14 Sep 2020 04:09
Last Modified: 14 Sep 2020 08:00
URI: http://repository-tnmgrmu.ac.in/id/eprint/13133

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