The digestive system involvement of antiphospholipid syndrome: pathophysiology, clinical characteristics, and treatment strategies

Ann Med. 2021 Dec;53(1):1328-1339. doi: 10.1080/07853890.2021.1962964.

Abstract

Antiphospholipid syndrome (APS) is an autoimmune disease mainly characterised by vascular thrombosis and pregnancy morbidity. APS has broad spectrum of clinical manifestations. The digestive system involvement of antiphospholipid syndrome is a critical but under-recognised condition. Digestive system involvement may be the result of direct (autoimmune-mediated) or indirect (thrombotic) mechanisms. Liver is the most commonly involved organ, followed by intestines, oesophagus, stomach, pancreas and spleen. This review describes possible digestive system manifestations in APS patients, and illustrates the epidemiology and possible pathophysiology of APS. The role of different treatment strategies in the management of digestive system manifestations of APS were also discussed.Key messagesAntiphospholipid syndrome is a multi-organ, multi-system disease and its clinical manifestation spectrum is gradually expanding. Since the first diagnosis of APS, the clinical manifestations of digestive system have been reported successively. This narrative review describes the major digestive system manifestations of APS and illustrates the epidemiology, pathophysiology and the role of therapeutic strategies of these patients.

Keywords: Antiphospholipid syndrome; antiphospholipid antibodies; autoimmune; digestive system; thrombosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antibodies, Antiphospholipid / therapeutic use*
  • Antiphospholipid Syndrome / complications*
  • Antiphospholipid Syndrome / drug therapy*
  • Antiphospholipid Syndrome / physiopathology
  • Autoimmune Diseases
  • Digestive System / physiopathology*
  • Female
  • Humans
  • Pregnancy
  • Thrombosis / epidemiology
  • Thrombosis / etiology

Substances

  • Antibodies, Antiphospholipid

Grants and funding

This work was supported by National Natural Science Foundation of China [JS, grant number 81770374; CL, grant number 82000347]; Jilin Province Science and technology development plan project [YGW, grant number 20190701066GH]; Department of education of Jilin Province [YGW, grant number JJKH20201046KJ]. Education Department of Jilin Province; Jilin Scientific and Technological Development Program;