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Catastrophic Antiphospholipid Syndrome Mortality Assessed

Recommended treatment is anticoagulants, corticosteroids and plasma exchange

WEDNESDAY, Aug. 23 (HealthDay News) -- Stroke, cerebral hemorrhage and encephalopathy are major causes of death in patients with catastrophic antiphospholipid syndrome (CAPS), and the risk of death increases in those with systemic lupus erythematosus, according to a study published in the August issue of Arthritis & Rheumatism.

Ricard Cervera, M.D., of Servei de Malalties Autoimmunes, Hospital Clinic, in Barcelona, Spain, and colleagues analyzed case reports on 250 patients who were enrolled in the CAPS Registry from 2001 until February 2005.

The researchers found that 56 percent of the patients recovered, and 44 percent died. They identified the main causes of death as cerebral involvement (27.2 percent), cardiac involvement (19.8 percent) and infection (19.8 percent) and determined that the presence of systemic lupus erythematosus was associated with a higher mortality rate. Treatment with a combination of anticoagulants, corticosteroids and plasma exchange was associated with a higher recovery rate (77.8 percent), followed by anticoagulants, corticosteroids, plus plasma exchange and/or intravenous immunoglobulins (69 percent).

"According to the results of the present study, anticoagulants plus corticosteroids plus plasma exchange should be the first line of therapy in patients with CAPS," they concluded. "Further prospective studies using large-scale registries such as the CAPS Registry will help us to better assess the prognostic factors and appropriate treatment of patients with CAPS."

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