Antiphospholipid syndrome physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]
Overview
Physical examination shows no pathognomonic physical findings of antiphospholipid syndrome (APS); however, abnormal features may be found on examination that are related to infarction or ischemia of the skin, viscera, or the central nervous system leading to cutaneous and neurological manifestations.
Physical Examination
Physical examination shows no pathognomonic physical findings of APS; however, abnormal features may be found on examination that are related to infarction or ischemia of the skin, viscera, or the central nervous system leading to cutaneous and neurological manifestations.
Appearance of the Patient
- Patients with APS usually appear normal.
Vital Signs
- Low-grade fever may be present in case of infectious cause of APS.
Cutaneous manifestations
Skin examination of patients with APS is usually positive for:[1][2][3]
- Venous thromboembolism
- Livedo reticularis
- Purpura
- Superficial thrombophelibitis
- Leg ulcers
- Splinter hemorrhages
- Gangrene of the distal extremities
- Leg swelling
HEENT
Abnormal fundoscopic examination findings:[4]
- Retinal artery occlusion findings
- Retinal vein thrombosis findings
Neck
- Neck examination of patients with APS can show lymphadenopathy.
Lungs
Pulmonary examination of patients with APS may show the following findings:
- Tachypnea in case of pulmonary embolism.
Heart
- Cardiovascular examination of patients with APS shows findings consistent with
- Heart valve disease
- Pericarditis
Abdomen
- Abdominal tenderness in the lower abdominal quadrant in case of miscarriage or fetal loss.
- Rebound tenderness
- Guarding may be present
Back
- Back examination of patients with APS is usually normal.
Genitourinary
- Genitourinary examination of patients with APS is usually normal.
Neuromuscular
- Neurological exam findings consistent with stroke or transient ischemic attack.[6]
- Migraine
- Vascular dementia
- Pre-eclampsia or eclampsia
References
- ↑ Cervera R, Piette JC, Font J, Khamashta MA, Shoenfeld Y, Camps MT; et al. (2002). "Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients". Arthritis Rheum. 46 (4): 1019–27. PMID 11953980.
- ↑ Ruiz-Irastorza G, Crowther M, Branch W, Khamashta MA (2010). "Antiphospholipid syndrome". Lancet. 376 (9751): 1498–509. doi:10.1016/S0140-6736(10)60709-X. PMID 20822807.
- ↑ Negrini S, Pappalardo F, Murdaca G, Indiveri F, Puppo F (2017). "The antiphospholipid syndrome: from pathophysiology to treatment". Clin Exp Med. 17 (3): 257–267. doi:10.1007/s10238-016-0430-5. PMID 27334977.
- ↑ Tektonidou MG, Varsou N, Kotoulas G, Antoniou A, Moutsopoulos HM (2006). "Cognitive deficits in patients with antiphospholipid syndrome: association with clinical, laboratory, and brain magnetic resonance imaging findings". Arch Intern Med. 166 (20): 2278–84. doi:10.1001/archinte.166.20.2278. PMID 17101948.
- ↑ Abreu MM, Danowski A, Wahl DG, Amigo MC, Tektonidou M, Pacheco MS; et al. (2015). "The relevance of "non-criteria" clinical manifestations of antiphospholipid syndrome: 14th International Congress on Antiphospholipid Antibodies Technical Task Force Report on Antiphospholipid Syndrome Clinical Features". Autoimmun Rev. 14 (5): 401–14. doi:10.1016/j.autrev.2015.01.002. PMID 25641203.
- ↑ Sciascia S, Amigo MC, Roccatello D, Khamashta M (2017). "Diagnosing antiphospholipid syndrome: 'extra-criteria' manifestations and technical advances". Nat Rev Rheumatol. 13 (9): 548–560. doi:10.1038/nrrheum.2017.124. PMID 28769114.