The clinical and laboratory manifestations profile of antiphospholipid syndrome among Saudi Arabia population: Examining the applicability of Sapporo criteria

Farjah H Algahtani; Fatmah S AlQahtany; Ghada ElGohary; Aynaa Alsharidi; Afsar Sayeeda; Hussein AlArfaj; Ahmed Y Gamal

doi:10.1016/j.sjbs.2020.05.037

The clinical and laboratory manifestations profile of antiphospholipid syndrome among Saudi Arabia population: Examining the applicability of Sapporo criteria

Saudi J Biol Sci. 2020 Sep;27(9):2425-2430. doi: 10.1016/j.sjbs.2020.05.037. Epub 2020 May 29.

Authors

Farjah H Algahtani¹, Fatmah S AlQahtany², Ghada ElGohary^{1

3}, Aynaa Alsharidi⁴, Afsar Sayeeda⁵, Hussein AlArfaj⁵, Ahmed Y Gamal¹

Affiliations

¹ Department of Medicine, Division of Oncology/Hematology, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia.
² Department of Pathology, Hematopathology Unit, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia.
³ Departement of Adult Hematology/Internal Medicine, Ain Shams University, College of Medicine, Cairo, Egypt.
⁴ Infectious Unit, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia.
⁵ Rheumatology Unit, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia.

Abstract

Antiphospholipid syndrome is a organized autoimmune disease presented with vascular thrombosis and pregnancy morbidity. The Sapporo classification criteria of APS were revised in 2006 and are used as the main diagnosis guideline, which validity as standard measurements is still in debate. This study observe the clinical and laboratory indices of APS among Saudi patients. This is a retrospective study hospital-based population. The clinical and Laboratory manifestations of diagnosed APS patients from electronical medical records identifies by ICD-9 code 795.79 in the King Saud University Medical City, Riyadh, Saudi Arabia, between 1990 and 2012. We selected patients with ICD-9 code 795.79 as. Sapporo criteria applied to all patients, then divided into cases fulfilled criteria and cases failed the criteria. To notice the difference in clinical and laboratory indices and comorbidities between the two groups, the T-test was performed and Logistic regression for the fulfilled criteria and clinical indices of vascular thrombosis, DVT/PE, recurrent, and pregnancy morbidity. A total of 72 (90%) females and 8 (10%) males, with the female-to-male ratio 9:1. The mean (±SD) age at diagnosis was 28.1 (±8.7) years (range 11-63 years). There were 22 patients (27.5%) attained the revised criteria (APS confirmed) and no significant difference between the two groups was observed (p > 0.2). However, we found Sapporo confirmed APS cases had significantly higher percentage of serological manifestation presence than clinically diagnosed APS cases. Though there is no statistically significance, Sapporo confirmed APS cases had advanced odds of undergoing vascular thrombosis (OR = 1.61, 95%CI) and DVT/PE (OR = 1.53, 95%CI) and lesser odds of undergoing recurrent DVT/PE (OR = 0.67, 95%CI) and pregnancy morbidity (OR = 0.63, 95%CI) than the clinically diagnosed APS cases. Over 70% of the study population with diagnosed APS did not accomplish the revised Sapporo criteria due to negative laboratory manifestations, which reflects heterogeneous but not degreed disease severity profiles.

Keywords: Antiphospholipid syndrome; Autoimmune disease; Pregnancy morbidity; Sapporo criteria; Vascular thrombosis.