CAPS criteria fail to identify most severely-ill thrombotic antiphospholipid syndrome patients requiring intensive care unit admission

被引：10

作者：

de Chambrun, Marc Pineton ^{[1
,2
]}

Larcher, Romaric ^{[3
,4
]}

Pene, Frederic ^{[5
,6
]}

Argaud, Laurent ^{[7
]}

Demoule, Alexandre ^{[8
]}

Jamme, Matthieu ^{[9
]}

Coudroy, Remi ^{[10
]}

Mathian, Alexis ^{[1
]}

Gibelin, Aude ^{[11
]}

Azoulay, Elie ^{[12
]}

Tandjaoui-Lambiotte, Yacine ^{[13
]}

Dargent, Auguste ^{[14
,15
]}

Beloncle, Francois-Michel ^{[16
]}

Raphalen, Jean-Herle ^{[17
]}

Couteau-Chardon, Amelie ^{[18
]}

de Prost, Nicolas ^{[19
]}

Devaquet, Jerome ^{[20
]}

Contou, Damien ^{[21
]}

Gaugain, Samuel ^{[22
]}

Trouiller, Pierre ^{[23
,24
]}

Grange, Steven ^{[25
]}

Ledochowski, Stanislas ^{[26
]}

Lemarie, Jeremie ^{[27
]}

Faguer, Stanislas ^{[28
]}

Degos, Vincent ^{[29
]}

Combes, Alain ^{[2
]}

Luyt, Charles-Edouard ^{[2
]}

Amoura, Zahir ^{[1
]}

机构：

[1] Sorbonne Univ, Syndrome Anticorps Antiphospholipides & Autres Ma, Ctr Reference Natl Lupus Syst,Serv Med Interne 2, Hop La Pitie Salpetriere,APHP,Inst E3M, Paris, France

[2] Sorbonne Univ, Inst Cardiometab & Nutr ICAN, Hop La Pitie Salpetriere, APHP,Serv Med Intens Reanimat, Paris, France

[3] Ctr Hosp Univ CHU Montpellier, Hop Lapeyronie, Serv Med Intens Reanimat, Montpellier, France

[4] Univ Montpellier, INSERM, CNRS, PhyMedExp, Montpellier, France

[5] Hop Cochin, Hop Univ Paris Ctr, APHP, Serv Med Intens Reanimat, Paris, France

[6] Univ Paris 05, Paris, France

[7] Hosp Civils Lyon, Hop Edouard Herriot, Serv Med Intens Reanimat, Lyon, France

[8] Sorbonne Univ, Serv Pneumol Med Intens & Reanimat Med, Neurophysiol Resp Expt & Clin,UMRS1158, Hop La Pitie Salperriere,APHP,Dept R3S,INSERM, Paris, France

[9] Sorbonne Univ, Hop Tenon, APHP, Serv Urgences Nephrol & Transplantat Renale, Paris, France

[10] Univ Poitiers, CHU Poitiers, Serv Med Intens Reanimat, INSERM,C1C1402,Grp ALIVE, Poitiers, France

[11] Sorbonne Univ, Serv Reanimat Medicochirurg, Hop Tenon, APHP,Pole Thorax Voies Aeriennes, Paris, France

[12] Hop St Louis, APHP, Serv Med Intens Reanimat, Paris, France

[13] HUPSSD, Hop Avicenne, APHP, Serv Reanimat Medicochirurg, Bobigny, France

[14] CHU Dijon, Serv Med Intens Reanimat, Dijon, France

[15] INSERM, UMR 1231 LabEx Lipst, Dijon, France

[16] Univ Angers, CHU Angers, Dept Med Intens Reanimat & Med Hyperbare, Angers, France

[17] Univ Paris 05, Hop Necker, APHP, Serv Anesthesie & Reanimat, Paris, France

[18] Univ Paris 05, Hop Europeen George Pompidou, APHP, Serv Med Intens Reanimat, Paris, France

[19] CHU Henri Mondor, APHP, Serv Med Intens Reanimat, Creteil, France

[20] Hop Foch, Serv Reanimat Polyvalente, Suresnes, France

[21] Ctr Hosp Victor Dupouy, Serv Reanimat Polyvalente, Argenteuil, France

[22] Univ Paris Diderot, Hop St Louis Lariboisiere, APHP, Dept Anesthesie & Reanimat, Paris, France

[23] Hop Univ Paris Sud, Hop Antoine Beclere, APHP, Serv Reanimat Polyvalente, Clamart, France

[24] Hop Univ Paris Sud, Hop Antoine Beclere, APHP, Unite Surveillance Continue, Clamart, France

[25] CHU Rouen, Hop Charles Nicolle, Serv Med Intens Reanimat, Rouen, France

[26] CH Pierre Oudot, Serv Reanimat Polyvalente, Bourgoin Jallieu, France

[27] CHRU Nancy, Hop Cent, Serv Reanimat Med, Nancy, France

[28] CHU Toulouse, Ctr Reference Malad Renales Rares, Dept Nephrol & Transplantat Organes, Unite Reanimat,Hop Rangueil, Toulouse, France

[29] Sorbonne Univ, Hop La Pitie Salpetriere, APHP, Serv Reanimat Neurochirurg, Paris, France

来源：

JOURNAL OF AUTOIMMUNITY | 2019年 / 103卷

关键词：

Antiphospholipid syndrome; Catastrophic antiphospholipid syndrome; Intensive care unit; Systemic lupus erythematosus; INTERNATIONAL CONSENSUS STATEMENT; CLASSIFICATION CRITERIA; DESCRIPTIVE ANALYSIS; VALIDATION; MANAGEMENT; DIAGNOSIS; MORTALITY; SCORE;

D O I：

10.1016/j.jaut.2019.06.003

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Purpose: Catastrophic antiphospholipid syndrome (CAPS), the most severe manifestation of antiphospholipid syndrome (APS), is characterised by simultaneous thromboses in multiple organs. Diagnosing CAPS can be challenging but its early recognition and management is crucial for a favourable outcome. This study was undertaken to evaluate the frequencies, distributions and ability to predict mortality of "definite/probable" or "no-CAPS" categories of thrombotic APS patients requiring admission to the intensive care unit (ICU). Methods: This French national multicentre retrospective study, conducted from January 2000 to September 2018, included all APS patients with any new thrombotic manifestation(s) admitted to 24 ICUs. Results: One hundred and thirty-four patients (male/female ratio: 0.4; mean age at admission: 45.4 +/- 15.0 years), who experienced 152 CAPS episodes, required ICU admission. The numbers of definite, probable or noCAPS episodes, respectively, were: 11 (7.2%), 60 (39.5%) and 81 (53.3%). No histopathological proof of microvascular thrombosis was the most frequent reason for not being classified as definite CAPS. Overall, 35/152 (23.0%) episodes were fatal, with comparable rates for definite/probable CAPS and no CAPS (23% vs. 28.8% respectively, p = 0.4). The Kaplan-Meier curve of estimated probability of survival showed no between-group survival difference (log-rank test p = 0.5). Conclusions: In this study, CAPS criteria were not associated with mortality of thrombotic APS patients requiring ICU admission. Further studies are need evaluate the adequacy of CAPS criteria for critically-ill APS patients.

引用

页数：8

共 20 条

[1] Development and initial validation of a damage index (DIAPS) in patients with thrombotic antiphospholipid syndrome (APS) [J].