Late‐onset primary antiphospholipid syndrome in the elderly: a report of seven cases

• Published in: International journal of rheumatic diseases Vol. 18; no. 1; pp. 103 - 107
• Main Authors: Cherif, Yosra, Jallouli, Moez, Hriz, Hela, Gouiaa, Radhouane, Marzouk, Sameh, Snoussi, Mouna, Frikha, Faten, Masmoudi, Hatem, Bahloul, Zouhir
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-01-2015
• Subjects: Age of Onset; Aged; Aged, 80 and over; Antibodies, Antiphospholipid - blood; Anticoagulants - therapeutic use; Antiphospholipid Syndrome - blood; Antiphospholipid Syndrome - diagnosis; Antiphospholipid Syndrome - drug therapy; Antiphospholipid Syndrome - epidemiology; anti‐phospholipid antibody syndrome; Biomarkers - blood; Brain Ischemia - diagnosis; Brain Ischemia - epidemiology; clinical aspects; Female; Humans; Male; Predictive Value of Tests; Prevalence; Retrospective Studies; Risk Factors; Stroke - diagnosis; Stroke - epidemiology; Time Factors; Treatment Outcome; Tunisia - epidemiology; Venous Thrombosis - diagnosis; Venous Thrombosis - epidemiology; Tunisia; clinical aspects; anti-phospholipid antibody syndrome
• ISSN: 1756-1841; 1756-185X
• DOI: 10.1111/1756-185X.12494

Aim
We describe the clinical profile of elderly with primary antiphospholipid syndrome (APS).
Methods
Charts of seven elderly patients diagnosed with APS between 1996 and 2012 were retrospectively assessed.
Results
The mean age at diagnosis was 77 ± 6 years (67–84 years). Two patients had experienced frequent miscarriages. Five patients presented with deep venous thrombosis of the lower limb, one had venous thrombosis of the upper limb and brachiocephalic vein and another had a cerebral ischemic stroke. The antiphospholipid antibodies tests revealed the presence of significant amounts of anticardiolipin antibodies, 12 weeks apart, twice in four patients. The antibodies to β2‐glycoprotein 1 were positive twice in two patients and lupus anticoagulant in one of these. All patients were treated with heparin and long‐term anti‐vitamin K and thrombosis was cleared in all cases. Two patients presented with bleeding complications: hematuria and hematoma of the buttock in one patient and rectal bleeding in another case. Two elderly developed a colon cancer and lymphoma 1 year later.
Conclusion
In this report, we report on primary APS in the elderly, to discuss its prevalence and the clinical significance of positive antiphospholipid antibodies in subjects over the age of 65 years.