%0 Journal Article
%T Thrombosis in Systemic Lupus Erythematosus: A Review Article
%A Ibrahim A. Al-Homood
%J ISRN Rheumatology
%D 2012
%R 10.5402/2012/428269
%X Thrombosis is a well-known clinical entity in systemic lupus erythematosus (SLE), and it is multifactorial. The most important risk factor is the presence of antiphospholipid antibodies (APLAs). However, approximately 40% of adults with SLE who are negative for APL A are diagnosed with thrombosis, indicating the importance of other risk factors. Thus, the thrombosis risk factors should be evaluated extensively and regularly and treated aggressively in every patient with systemic lupus erythematosus. 1. Introduction Systemic lupus erythematosus (SLE) is an autoimmune disease with diverse clinical manifestations that primarily affects young women. Women are affected nine times more frequently than men [1]. Of patients with SLE, 65% have disease onset between ages 16 and 55, 20% present before age 16, and 15% present after the age of 55 [2]. Estimated incidence rates in North America, South America, and Europe range from 2 to 8 per 100,000 per year [1]. Prevalence rates of SLE are estimated to be 51 per 100,000 in the United States [3], while in Saudi Arabia were estimated to be 19.28 per 100,000 population based on study done in the Al-Qaseem region [4]. Patients may be classified as having SLE if they fulfill four or more of American College of Rheumatology (ACR) classification criteria (Table 1). Table 1: American College of Rheumatology (ACR) revised classification criteria for systemic lupus erythematosus. 2. Thrombosis in SLE Patients with SLE have an increased risk for thrombosis. Arterial and/or venous thrombosis is a well-known clinical entity in SLE, with a prevalence >10%. This prevalence may even exceed 50% in high-risk patients [5]. The incidence of thrombosis in SLE patients according to two inception cohorts was 26.8 [6] and up to 51.9 per 1000 patient-years, according to the disease duration [7]. Other study reported that the incidence of thrombosis was 36.3 per 1000 patient-years [8]. In a 10-year prospective cohort study of patients with SLE, the most frequent causes of death were active SLE (26.5%), thrombosis (26.5%), and infection (25%), with thrombosis dominating the second 5-year period of followup [9]. The age at onset of thrombosis in SLE patient is lower than that of general population which is a major concern. The incidence of thrombosis increased in the first year. Possible reasons for this early higher incidence of thrombosis could be the high levels of disease activity and circulating immune complexes, cytotoxic antibodies, or a higher inflammatory state [10]. 3. Risk Factors of Thrombosis in SLE There are several factors that
%U http://www.hindawi.com/journals/isrn.rheumatology/2012/428269/