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Acute Respiratory Syndrome Lethal in Autoimmune Patients

Half of patients with catastrophic antiphospholipid disease have respiratory involvement

FRIDAY, Dec. 16 (HealthDay News) -- Acute respiratory distress syndrome (ARDS) is a common event in patients with "catastrophic" antiphospholipid autoimmune disease, according to a report in the January issue of Annals of the Rheumatic Diseases. Patients with antiphospholipid disease who present with ARDS should be suspected of the catastrophic version of the disease, which is characterized by multiorgan failure due to small vessel occlusion.

Ricard Cervera, M.D., of the Institut d'Investigacions Biomèdiques in Catalonia, Spain, and colleagues examined data from the catastrophic antiphospholipid syndrome registry. In February 2004 the registry included 220 patients, 153 of whom were female, with an average age of 38 years.

The authors found 68% of the patients had a pulmonary complaint and 21% had been diagnosed with ARDS. Forty percent of the patients with ARDS had died and many of these patients had thrombotic microangiopathy upon pathological examination.

"ARDS is the dominant pulmonary manifestation of catastrophic antiphospholipid syndrome," the authors conclude. "Our study shows that catastrophic antiphospholipid syndrome is a major risk factor for the development of ARDS."

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