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{{Antiphospholipid syndrome}}
{{Antiphospholipid syndrome}}
{{CMG}}{{AE}}{{FT}}
{{CMG}}; {{AE}}{{FT}}


==Overview==
==Overview==
Physical examination shows no pathognomonic physical findings of antiphospholipid syndrome (APS); however, abnormal features may be found on examination that are related to infarction or ischemia of the skin, viscera, or the central nervous system leading to cutaneous and neurological manifestations.
==Physical Examination==
Physical examination shows no pathognomonic physical findings of APS; however, abnormal features may be found on examination that are related to infarction or ischemia of the skin, viscera, or the central nervous system leading to cutaneous and neurological manifestations.
===Appearance of the Patient===
*Patients with APS usually appear normal.
===Vital Signs===
*Low-grade fever may be present in case of infectious cause of APS.
===Cutaneous manifestations===
Skin examination of patients with APS is usually positive for:<ref name="pmid11953980">{{cite journal| author=Cervera R, Piette JC, Font J, Khamashta MA, Shoenfeld Y, Camps MT et al.| title=Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients. | journal=Arthritis Rheum | year= 2002 | volume= 46 | issue= 4 | pages= 1019-27 | pmid=11953980 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11953980  }} </ref><ref name="pmid20822807">{{cite journal| author=Ruiz-Irastorza G, Crowther M, Branch W, Khamashta MA| title=Antiphospholipid syndrome. | journal=Lancet | year= 2010 | volume= 376 | issue= 9751 | pages= 1498-509 | pmid=20822807 | doi=10.1016/S0140-6736(10)60709-X | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20822807  }} </ref><ref name="pmid27334977">{{cite journal| author=Negrini S, Pappalardo F, Murdaca G, Indiveri F, Puppo F| title=The antiphospholipid syndrome: from pathophysiology to treatment. | journal=Clin Exp Med | year= 2017 | volume= 17 | issue= 3 | pages= 257-267 | pmid=27334977 | doi=10.1007/s10238-016-0430-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27334977  }} </ref>
*[[Venous thromboembolism]]
*[[Livedoid vasculitis|Livedo reticularis]]
*[[Purpura]]
*Superficial thrombophelibitis
*Leg ulcers
*[[Splinter hemorrhage|Splinter]] [[Bleeding|hemorrhages]]
*[[Gangrene]] of the distal extremities
*Leg swelling
===HEENT===
Abnormal fundoscopic examination findings:<ref name="pmid17101948">{{cite journal| author=Tektonidou MG, Varsou N, Kotoulas G, Antoniou A, Moutsopoulos HM| title=Cognitive deficits in patients with antiphospholipid syndrome: association with clinical, laboratory, and brain magnetic resonance imaging findings. | journal=Arch Intern Med | year= 2006 | volume= 166 | issue= 20 | pages= 2278-84 | pmid=17101948 | doi=10.1001/archinte.166.20.2278 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17101948  }} </ref>
*[[Retinal]] artery occlusion findings
*Retinal vein [[thrombosis]] findings
===Neck===
* Neck examination of patients with APS can show [[lymphadenopathy]].
===Lungs===
Pulmonary examination of patients with APS may show the following findings:
*[[Tachypnea]] in case of pulmonary embolism.
===Heart===
* Cardiovascular examination of patients with APS shows findings consistent with
* Heart valve disease
* [[Pericarditis]]
===Abdomen===
* [[Hepatomegaly]]<ref name="pmid25641203">{{cite journal| author=Abreu MM, Danowski A, Wahl DG, Amigo MC, Tektonidou M, Pacheco MS et al.| title=The relevance of "non-criteria" clinical manifestations of antiphospholipid syndrome: 14th International Congress on Antiphospholipid Antibodies Technical Task Force Report on Antiphospholipid Syndrome Clinical Features. | journal=Autoimmun Rev | year= 2015 | volume= 14 | issue= 5 | pages= 401-14 | pmid=25641203 | doi=10.1016/j.autrev.2015.01.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25641203  }} </ref>
* [[Splenomegaly]]
*[[Abdominal tenderness]] in the lower abdominal quadrant in case of miscarriage or fetal loss.
*[[Rebound tenderness]]
*Guarding may be present
===Back===
* Back examination of patients with APS is usually normal.
===Genitourinary===
* Genitourinary examination of patients with APS is usually normal.
===Neuromuscular===
* Neurological exam findings consistent with [[stroke]] or [[Transient ischemic attack|transient]] ischemic attack.<ref name="pmid28769114">{{cite journal| author=Sciascia S, Amigo MC, Roccatello D, Khamashta M| title=Diagnosing antiphospholipid syndrome: 'extra-criteria' manifestations and technical advances. | journal=Nat Rev Rheumatol | year= 2017 | volume= 13 | issue= 9 | pages= 548-560 | pmid=28769114 | doi=10.1038/nrrheum.2017.124 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28769114  }} </ref>
* [[Migraine]]
* [[Multi-infarct dementia|Vascular dementia]]
* [[Pre-eclampsia]] or [[eclampsia]]


==References==
==References==

Latest revision as of 20:26, 24 April 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

Physical examination shows no pathognomonic physical findings of antiphospholipid syndrome (APS); however, abnormal features may be found on examination that are related to infarction or ischemia of the skin, viscera, or the central nervous system leading to cutaneous and neurological manifestations.

Physical Examination

Physical examination shows no pathognomonic physical findings of APS; however, abnormal features may be found on examination that are related to infarction or ischemia of the skin, viscera, or the central nervous system leading to cutaneous and neurological manifestations.

Appearance of the Patient

  • Patients with APS usually appear normal.

Vital Signs

  • Low-grade fever may be present in case of infectious cause of APS.

Cutaneous manifestations

Skin examination of patients with APS is usually positive for:[1][2][3]

HEENT

Abnormal fundoscopic examination findings:[4]

Neck

Lungs

Pulmonary examination of patients with APS may show the following findings:

Heart

  • Cardiovascular examination of patients with APS shows findings consistent with
  • Heart valve disease
  • Pericarditis

Abdomen

Back

  • Back examination of patients with APS is usually normal.

Genitourinary

  • Genitourinary examination of patients with APS is usually normal.

Neuromuscular

References

  1. ↑ Cervera R, Piette JC, Font J, Khamashta MA, Shoenfeld Y, Camps MT; et al. (2002). "Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients". Arthritis Rheum. 46 (4): 1019–27. PMID 11953980.
  2. ↑ Ruiz-Irastorza G, Crowther M, Branch W, Khamashta MA (2010). "Antiphospholipid syndrome". Lancet. 376 (9751): 1498–509. doi:10.1016/S0140-6736(10)60709-X. PMID 20822807.
  3. ↑ Negrini S, Pappalardo F, Murdaca G, Indiveri F, Puppo F (2017). "The antiphospholipid syndrome: from pathophysiology to treatment". Clin Exp Med. 17 (3): 257–267. doi:10.1007/s10238-016-0430-5. PMID 27334977.
  4. ↑ Tektonidou MG, Varsou N, Kotoulas G, Antoniou A, Moutsopoulos HM (2006). "Cognitive deficits in patients with antiphospholipid syndrome: association with clinical, laboratory, and brain magnetic resonance imaging findings". Arch Intern Med. 166 (20): 2278–84. doi:10.1001/archinte.166.20.2278. PMID 17101948.
  5. ↑ Abreu MM, Danowski A, Wahl DG, Amigo MC, Tektonidou M, Pacheco MS; et al. (2015). "The relevance of "non-criteria" clinical manifestations of antiphospholipid syndrome: 14th International Congress on Antiphospholipid Antibodies Technical Task Force Report on Antiphospholipid Syndrome Clinical Features". Autoimmun Rev. 14 (5): 401–14. doi:10.1016/j.autrev.2015.01.002. PMID 25641203.
  6. ↑ Sciascia S, Amigo MC, Roccatello D, Khamashta M (2017). "Diagnosing antiphospholipid syndrome: 'extra-criteria' manifestations and technical advances". Nat Rev Rheumatol. 13 (9): 548–560. doi:10.1038/nrrheum.2017.124. PMID 28769114.
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