Antiphospholipid syndrome physical examination: Difference between revisions
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===Cutaneous manifestations=== | ===Cutaneous manifestations=== | ||
Skin examination of patients with APS is usually positive for: | 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]] | *[[Venous thromboembolism]] | ||
*[[Livedoid vasculitis|Livedo reticularis]] | *[[Livedoid vasculitis|Livedo reticularis]] | ||
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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]
- Venous thromboembolism
- Livedo reticularis
- Purpura
- Superficial thrombophelibitis
- Leg ulcers
- Splinter hemorrhages
- Gangrene of the distal extremities
- Leg swelling
HEENT
Abnormal fundoscopic examination findings:
- 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
- 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.
- Migraine
- Vascular dementia
- Pre-eclampsia or eclampsia
References
- ↑ 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.
- ↑ 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.
- ↑ 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.