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Revista Uruguaya de Medicina Interna

On-line version ISSN 2393-6797


RODRIGUEZ CASA, Virginia; CONSANI FERNANDEZ, Sandra; MOREIRA MILANESI, Emilia  and  FACAL CASTRO, Jorge. Clinical manifestations "not criteria" of Antiphospholipid Syndrome. Presentation of a national cohort. Rev. Urug. Med. Int. [online]. 2023, vol.8, n.2, pp.26-37.  Epub July 01, 2023. ISSN 2393-6797.


Antiphospholipid syndrome (APS) is an autoimmune condition characterized by thrombosis, recurrent fetal loss, and antiphospholipid antibodies. There are clinical manifestations not contemplated in the classification criteria, which are called non-criterion manifestations.


To analyze the clinical manifestations of APS, emphasizing the non-criterion manifestations and their relationship with the autoantibody profile in a general hospital in Montevideo, Uruguay.


A retrospective analysis of the medical records of patients with a definitive or suspected diagnosis of APS in an outpatient medicine service for autoimmune diseases, at the Maciel Hospital, assisted between 2010 and 2019, was carried out.


78 patients were included, with a mean age of 50.3 +/- 14.5 years, 69 (88.5%) were female. Forty-six (59.0%) patients presented secondary APS, of which 28 (35.9%) associated SLE. Venous thrombosis of the lower limbs was the most frequent manifestation (51.3%). Eighteen (24.0%) patients presented arterial thrombosis in the form of cerebrovascular accident. Fifty-nine (75.6%) cases presented, in addition to the classification manifestations, some of the "non-criterion" manifestations and these manifested in an isolated way in 10 (12.8%) patients. The most frequent non-classifying manifestations were arthralgia, livedo reticularis, migraine and thrombocytopenia. A significant association was observed between the presence of anti-β2GPI with cutaneous manifestations and thrombocytopenia with at least one thrombotic manifestation.


Non-criterion manifestations of APS occurred in almost 3 out of 4 cases, a frequency similar to that observed in other series. The isolated presence of “non-criterion” manifestations could lead to suspicion of APS and, in some cases, lead to the request for antibodies.

Keywords : antiphospholipid syndrome; "non-criterion" clinical manifestations; autoantibodies.

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