Antiphospholipid syndrome: description of a cohort from Colombia and evaluation of thrombosis risk factors

Introduction Antiphospholipid syndrome is an autoimmune disease characterized by vascular thrombosis and gestational morbidity in the presence of antiphospholipid antibodies. Several risk factors for the development of thrombosis have been described in these patients, but the studies are heterogeneous and do not discriminate between arterial and venous events. Objective To describe the clinical and immunological manifestations of antiphospholipid syndrome in a cohort of Colombian patients and to establish risk factors for the development of arterial and venous thrombosis. Materials and Methods We conducted a cross-sectional analytical study. Inclusion criteria: 2006 Sydney Consensus Statement and classification in secondary antiphospholipid syndrome according to the American College of Rheumatology criteria. Results We included 100 patients, 84 of them women, with a mean age of 37.6 years. 59% of patients fulfilled secondary antiphospholipid syndrome criteria. The most common clinical manifestation during the initial evaluation and follow-up visit was venous thrombosis (56.52% and 47%, respectively), followed by “non-criteria” manifestations (23.91%), especially neurological. Deep venous thrombosis was recurrent in 46%, and 30% of individuals presented severe thrombocytopenia. Absence of specific autoantibodies discriminated between primary and secondary forms. Diabetes mellitus was a significant risk factor for venous thrombosis (6.4% vs. 0%, OR 2.205: 95% CI 1.772–2.742) and smoking for cerebrovascular disease (33.3% vs. 6%, OR 7.9, 95% CI 1.5–41.324). Conclusions This cohort of Colombian patients with antiphospholipid syndrome had a high percentage of events not included in the classification criteria, with severe, atypical, and recurrent organic involvement.