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2. Associations Among Antiphospholipid Antibody Types, Isotypes, and Titers: An AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Study

Author

Pons-Estel, Guillermo, Giannakopoulos, Bill, Krilis, Steve, de Jesus, Guilherme, Levy, Roger, Signorelli, Flavio, Andrade, Danieli, Balbi, Gustavo, Clarke, Ann E., Skeith, Leslie, Fortin, Paul R., Ji, Lanlan, Zhang, Zhouli, Yang, Chengde, Shi, Hui, Zuily, Stephane, Wahl, Denis, Tektonidou, Maria G., Nalli, Cecilia, Andreoli, Laura, Tincani, Angela, Chighizola, Cecilia B., Gerosa, Maria, Meroni, Pierluigi, Pengo, Vittorio, Cheng, Chunyan, Pazzola, Giulia, Sciascia, Savino, Foddai, Silvia, Radin, Massimo, Davis, Stacy, Amengual, Olga, Atsumi, Tatsuya, Uthman, Imad, Limper, Maarten, Groot, Philip de, Ruiz—Irastorza, Guillermo, Ugarte, Amaia, Rodriguez-Pinto, Ignasi, Cervera, Ricard, Pardos-Gea, Jose, Rodriguez Almaraz, Esther, Cuadrado, Maria Jose, Aguirre Zamorano, Maria Angeles, Lopez-Pedrera, Chary, Artim-Esen, Bahar, Inanc, Murat, Bertolaccini, Maria Laura, Cohen, Hannah, Efthymiou, Maria, Khamashta, Munther, Mackie, Ian, Sanna, Giovanni, Knight, Jason, Zuo, Yu, Petri, Michelle, Leaf, Rebecca K., Roubey, Robert, Ortel, Thomas, Gonzalez, Emilio, Willis, Rohan, Kello, Nina, Belmont, Michael, Levine, Steven, Rand, Jacob, Barbhaiya, Medha, Erkan, Doruk, Salmon, Jane, Lockshin, Michael, Duarte Garcia, Ali A., Branch, D. Ware, Gkrouzman, Elena, Ruiz-Irastorza, Guillermo, Belmont, H. Michael, Rodriguez-Almaraz, Esther, Petri, Michelle A., and Knight, Jason S.

Published
2023
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4. Complications thrombotiques graves du syndrome des antiphospholipides et d'un lupus erythemateux dissemine non diagnostique

Author

Barber, Megan R.W., Clarke, Ann E., Adams, Corey D., and Skeith, Leslie

Subjects
Rivaroxaban, Lupus, Clopidogrel, Apixaban, Thrombocytopenic purpura -- Cases, Company legal issue, Health
Abstract

Un homme de 22 ans a consulte son medecin de famille pour une douleur intense au pied droit, accompagnee d'une coloration sombre et d'une hypoesthesie. Il avait des antecedents de [...]

Published
2023
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7. Severe thrombotic complications secondary to antiphospholipid syndrome and undiagnosed systemic lupus erythematosus

Author

Barber, Megan R.W., Clarke, Ann E., Adams, Corey D., and Skeith, Leslie

Subjects
Antiphospholipid syndrome -- Case studies -- Complications and side effects, Blood clot -- Case studies -- Risk factors, Systemic lupus erythematosus -- Case studies -- Complications and side effects, Thrombosis -- Case studies -- Risk factors, Health
Abstract

A 22-year-old man presented to his family physician with intense pain in, dusky discolouration of and reduced sensation to his right foot. He had a history of migraines and 2 [...]

Published
2022
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9. Identification of hypercoagulability with thrombelastography in patients with hip fracture receiving thromboprophylaxis

Author

You, Daniel, Skeith, Leslie, Korley, Robert, Cantle, Paul, Lee, Adrienne, McBeth, Paul, McDonald, Braedon, Buckley, Richard, Duffy, Paul, Martin, C. Ryan, Soo, Andrea, and Schneider, Prism

Subjects
Hip joint -- Fractures, Fracture fixation -- Complications and side effects, Venous thrombosis -- Risk factors -- Diagnosis, Health, Health care industry
Abstract

Background: Venous thromboembolism (VTE) is the second most common complication after hip fracture surgery. We used thrombelastography (TEG), a whole-blood, point-of-care test that can provide an overview of the clotting process, to determine the duration of hypercoagulability after hip fracture surgery. Methods: In this prospective study, consecutive patients aged 51 years or more with hip fractures (trochanteric region or neck) amenable to surgical treatment who presented to the emergency department were eligible for enrolment. Thrombelastography, including calculation of the coagulation index (CI) (combination of 4 TEG parameters for an overall assessment of coagulation) was performed daily from admission until 5 days postoperatively, and at 2 and 6 weeks postoperatively. All patients received 28 days of thromboprophylaxis. We used single-sample t tests to compare mean maximal amplitude (MA) values (a measure of clot strength) to the hypercoagulable threshold of greater than 65 mm, a predictor of in-hospital VTE. Results: Of the 35 patients enrolled, 11 (31%) were hypercoagulable on admission based on an MA value greater than 65 mm, and 29 (83%) were hypercoagulable based on a CI value greater than 3.0; the corresponding values at 6 weeks were 23 (66%) and 34 (97%). All patients had an MA value greater than 65 mm at 2 weeks. Patients demonstrated normal coagulation on admission (mean MA value 62.2 mm [standard deviation (SD) 6.3 mm], p = 0.01) but became significantly hypercoagulable at 2 weeks (mean 71.6 mm [SD 2.6 mm], p < 0.001). There was a trend toward persistent hypercoagulability at 6 weeks (mean MA value 66.2 mm [SD 3.8 mm], p = 0.06). Conclusion: More than 50% of patients remained hypercoagulable 6 weeks after fracture despite thromboprophylaxis. Thrombelastography MA thresholds or a change in MA over time may help predict VTE risk; however, further study is needed. Contexte : La thromboembolie veineuse (TEV) est la deuxième complication la plus courante après une chirurgie pour fracture de la hanche. Nous avons eu recours à la thromboélastographie, un test de sang total effectué au point d'intervention et donnant une idée du processus de coagulation, pour évaluer la durée de l'hypercoagulabilité à la suite d'une chirurgie pour fracture de la hanche. Méthodes : Cette étude prospective a été menée auprès de patients consécutifs admissibles de 51 ans et plus qui se sont présentés à l'urgence pour une fracture de la hanche (région trochantérienne ou col du fémur) pouvant faire l'objet d'un traitement chirurgical. Une thromboélastographie (TEG), qui comprenait le calcul de l'indice de coagulation (IC) [combinaison de 4 paramètres du TEG permettant une évaluation globale de la coagulation], a été réalisée chaque jour, de l'admission au cinquième jour postopératoire, de même qu'à 2 et à 6 semaines postopératoires. Tous les patients ont suivi une thromboprophylaxie de 28 jours. Nous avons réalisé des tests t pour échantillon unique afin de comparer l'amplitude maximale (AM) moyenne (une mesure de la résistance d'un caillot) au seuil d'hypercoagulabilité de plus de 65 mm, un prédicteur de TEV à l'hôpital. Résultats: Des 35 patients recrutés, 11 (31%) présentaient une hypercoagulabilité à l'admission selon une AM supérieure à 65 mm, et 29 (83%) présentaient une hypercoagulabilité selon un IC supérieur à 3,0; les valeurs correspondantes à 6 semaines étaient de 23 (66%) et de 34 (97%), respectivement. Tous les patients avaient une AM de plus de 65 mm à 2 semaines. Dans l'ensemble, les patients avaient une coagulation normale à l'admission (AM moyenne 62,2 mm [écart type (ET.) 6,3 mm], p = 0,01), mais présentaient une hypercoagulabilité importante à 2 semaines (moyenne 71,6 mm [ET. 2,6 mm], p < 0,001). L'hypercoagulabilité avait tendance à persister à 6 semaines (AM moyenne 66,2 mm [E.T. 3,8 mm], p = 0,06). Conclusion: Malgré la thromboprophylaxie, plus de 50% des patients présentaient toujours une hypercoagulabilité 6 semaines après leur fracture. Les seuils d'AM à la thromboélastographie et les changements de l'AM au fil du temps pourraient aider à prédire le risque de TEV, mais d'autres études sur le sujet sont nécessaires., Venous thromboembolism (VTE), which comprises deep vein thrombosis or pulmonary embolism, is one of the major causes of morbidity and mortality after hip fracture, and the VTE risk after hip [...]

Published
2021
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11. Anticoagulant interventions in hospitalized patients with COVID‐19: A scoping review of randomized controlled trials and call for international collaboration

Author

Tritschler, Tobias, Mathieu, Marie‐Eve, Skeith, Leslie, Rodger, Marc, Middeldorp, Saskia, Brighton, Timothy, Sandset, Per Morten, Kahn, Susan R., Angus, Derek C., Blondon, Marc, Bonten, Marc J., Cattaneo, Marco, Cushman, Mary, Derde, Lennie P.G., DeSancho, Maria T., Diehl, Jean‐Luc, Goligher, Ewan, Jilma, Bernd, Jüni, Peter, Lawler, Patrick R., Marietta, Marco, Marshall, John C., McArthur, Colin, Miranda, Carlos Henrique, Mirault, Tristan, Morici, Nuccia, Perepu, Usha, Schörgenhofer, Christian, Sholzberg, Michelle, Spyropoulos, Alex C., Webb, Steve A., Zarychanski, Ryan, Zuily, Stéphane, and Le Gal, Grégoire

Published
2020
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18. Romiplostim drug presence in pregnancy and lactation

Author

Labrecque, Audrey Ann, primary, Roy, Steven, additional, Young, Daniel, additional, Chen, Si An, additional, Brechenmacher, Laurent, additional, Le, Doan, additional, Cooper, Stephanie, additional, Gibson, Paul Stephen, additional, Clarke, Ann E, additional, Dufour, Antoine, additional, and Skeith, Leslie, additional

Published
2023
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21. Hypercoagulability and Inflammatory Markers in a Case of Congenital Thrombotic Thrombocytopenic Purpura Complicated by Fetal Demise

Author

Skeith, Leslie, primary, Hurd, Kelle, additional, Chaturvedi, Shruti, additional, Chow, Lorraine, additional, Nicholas, Joshua, additional, Lee, Adrienne, additional, Young, Daniel, additional, Goodyear, Dawn, additional, Soucie, Jennifer, additional, Girard, Louis, additional, Dufour, Antoine, additional, and Agbani, Ejaife O., additional

Published
2022
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23. Challenges facing early career women in thrombosis and hemostasis—meeting the needs of the next generation

Author

Poole, Lauren, primary, Casari, Caterina, additional, Manevski, Sofija Dunjic, additional, Eslick, Renee, additional, Weitz, Jeffrey I., additional, Al Moosawi, Muntadhar, additional, Armstrong, Paul, additional, Campbell, Robert, additional, Chiasakul, Thita, additional, Iding, Aaron, additional, Kohli, Shrey, additional, Poole, Lauren, additional, Potere, Nicola, additional, Sayar, Zara, additional, and Skeith, Leslie, additional

Published
2022
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25. Feasibility of establishing a Canadian Obstetric Survey System (CanOSS) for severe maternal morbidity: a study protocol

Author

D’Souza, Rohan, primary, Seymour, Rebecca J, additional, Knight, Marian, additional, Dzakpasu, Susie, additional, Joseph, K S, additional, Thorne, Sara, additional, Ospina, Maria B, additional, Barrett, Jon, additional, Cook, Jocelynn, additional, Fell, Deshayne B, additional, Scott, Heather, additional, Metcalfe, Amy, additional, van den Akker, Thomas, additional, Lapinsky, Stephen, additional, Skeith, Leslie, additional, Murray-Davis, Beth, additional, Shah, Prakesh, additional, Forte, Milena, additional, Ashraf, Rizwana, additional, Chundamala, Josie, additional, Hutchinson, Sarah A, additional, Chen, Kenneth K, additional, and Malhamé, Isabelle, additional

Published
2022
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27. Risk of Recurrence after Stopping Anticoagulants in Women with Combined Oral Contraceptive-Associated Venous Thromboembolism: A Systematic Review and Meta-Analysis

Author

Abdulrehman, Jameel, primary, Elbaz, Carolyne, additional, Aziz, David, additional, Parpia, Sameer, additional, Le Gal, Gregoire, additional, Fazelzad, Rouhi, additional, Eischer, Lisbeth, additional, Cannegieter, Suzanne, additional, Ten Cate-Hoek, Arina J., additional, Nagler, Michael, additional, Schulman, Sam, additional, Rezende, Suely M, additional, Olie, Valerie, additional, Palareti, Gualtiero, additional, Marcucci, Maura, additional, Douketis, James, additional, Poli, Daniela, additional, Zabczyk, Michal, additional, Aguiar de Sousa, Diana, additional, Miranda, Bruno, additional, Cushman, Mary, additional, Tosetto, Alberto, additional, Kearon, Clive, additional, and Skeith, Leslie, additional

Published
2021
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29. Impact of the COVID‐19 pandemic on education and clinical training

Author

Al Moosawi, Muntadhar, primary, Iding, Aaron, additional, Armstrong, Paul, additional, Chiasakul, Thita, additional, Campbell, Robert, additional, Casari, Caterina, additional, McLintock, Claire, additional, Al Moosawi, Muntadhar, additional, Brazilek, Rose, additional, Dunjic Manevski, Sofija, additional, Eslick, Renee, additional, Kohli, Shrey, additional, Poole, Lauren, additional, and Skeith, Leslie, additional

Published
2021
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31. Development and implementation of common data elements for venous thromboembolism research: on behalf of SSC Subcommittee on official Communication from the SSC of the ISTH

Author

Le Gal, Grégoire, primary, Carrier, Marc, additional, Castellucci, Lana A., additional, Cuker, Adam, additional, Hansen, John‐Bjarne, additional, Klok, Frederikus A., additional, Langlois, Nicole J., additional, Levy, Jerrold H., additional, Middeldorp, Saskia, additional, Righini, Marc, additional, Walters, Sam, additional, Klok, Erik, additional, Bauman Kreuziger, Lisa, additional, Schulman, Sam, additional, Skeith, Leslie, additional, Zakai, Neil, additional, Riva, Nicoletta, additional, Douxfils, Jonathan, additional, Kahn, Susan, additional, Ten Cate‐Hoek, Arina, additional, Konstantinides, Stavros, additional, Ghanima, Waleed, additional, Lang, Irene, additional, Galanaud, Jean‐Philippe, additional, Moumneh, Thomas, additional, Gandara, Esteban, additional, Prandoni, Paolo, additional, Witmer, Char, additional, Lazo‐Langner, Alejandro, additional, Robert‐Ebadi, Helia, additional, Ní Áinle, Fionnuala, additional, Wu, Cynthia, additional, Wang, Tzu‐Fei, additional, Zwicker, Jeffrey, additional, Lauw, Mandy, additional, Ay, Cihan, additional, Maus, Gabriela Cesarman, additional, Angchaisuksiri, Pantep, additional, Steiner, Marie, additional, Bartz, Raquel, additional, Connors, Jean, additional, Samama, Marc, additional, Spyropoulos, Alex, additional, Faraoni, David, additional, Iba, Toshiaki, additional, Kearon, Clive, additional, Canniegeter, Suzanne, additional, Morange, Pierre, additional, Brækkan, Sigrid, additional, Morelli, Vania, additional, and Orsi, Fernanda, additional

Published
2021
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33. Exciting times for the ISTH early career professionals

Author

Kulkarni, Ketan, primary, Chiasakul, Thita, additional, Riva, Nicoletta, additional, Eslick, Renée, additional, Casari, Caterina, additional, Pabinger, Ingrid, additional, Blondon, Marc, additional, Boulaftali, Yacine, additional, Campbell, Robert, additional, Las Casas, Pedro, additional, Lauw, Mandy, additional, Muia, Joshua, additional, and Skeith, Leslie, additional

Published
2020
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45. Kidney and Pancreatic Extramedullary Relapse in Adult Acute Lymphoblastic Leukemia: A Case Report and Review of the Literature

Author

Skeith, Leslie, Lazo-Langner, Alejandro, and Mangel, Joy

Subjects
Article Subject
Abstract

Extramedullary relapse of acute lymphoblastic leukemia (ALL) is rare and has been primarily reported in pediatric patients or hematopoietic stem cell transplant recipients. We report a case of a 62-year-old woman who presented with relapsed ALL involving her kidneys, pancreas, and bone marrow 2 years after completing chemotherapy with a standard ALL protocol. Unfortunately, her extramedullary disease progressed despite treatment. To the best of our knowledge, this is the first reported case of extramedullary relapse of B-cell ALL to the kidneys and pancreas occurring in an adult patient who had not previously undergone a hematopoietic stem cell transplant. A literature review of kidney and pancreatic extramedullary relapse in ALL is also included.

Published
2013
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48. Associations Among Antiphospholipid Antibody Types, Isotypes, and Titers: An AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Study

Author

Gkrouzman, Elena, Willis, Rohan, Andrade, Danieli, Tektonidou, Maria G., Pengo, Vittorio, Ruiz-Irastorza, Guillermo, Belmont, H. Michael, Fortin, Paul R., Gerosa, Maria, Signorelli, Flavio, Atsumi, Tatsuya, Branch, D. Ware, Nalli, Cecilia, Rodriguez-Almaraz, Esther, Petri, Michelle A., Cervera, Ricard, Knight, Jason S., Efthymiou, Maria, Cohen, Hannah, Bertolaccini, Maria Laura, Erkan, Doruk, Roubey, Robert, Pons-Estel, Guillermo, Giannakopoulos, Bill, Krilis, Steve, de Jesus, Guilherme, Levy, Roger, Signorelli, Flavio, Andrade, Danieli, Balbi, Gustavo, Clarke, Ann E., Skeith, Leslie, Fortin, Paul R., Ji, Lanlan, Zhang, Zhouli, Yang, Chengde, Shi, Hui, Zuily, Stephane, Wahl, Denis, Tektonidou, Maria G., Nalli, Cecilia, Andreoli, Laura, Tincani, Angela, Chighizola, Cecilia B., Gerosa, Maria, Meroni, Pierluigi, Pengo, Vittorio, Cheng, Chunyan, Pazzola, Giulia, Sciascia, Savino, Foddai, Silvia, Radin, Massimo, Davis, Stacy, Amengual, Olga, Atsumi, Tatsuya, Uthman, Imad, Limper, Maarten, Groot, Philip de, Ruiz—Irastorza, Guillermo, Ugarte, Amaia, Rodriguez-Pinto, Ignasi, Cervera, Ricard, Pardos-Gea, Jose, Rodriguez Almaraz, Esther, Cuadrado, Maria Jose, Aguirre Zamorano, Maria Angeles, Lopez-Pedrera, Chary, Artim-Esen, Bahar, Inanc, Murat, Bertolaccini, Maria Laura, Cohen, Hannah, Efthymiou, Maria, Khamashta, Munther, Mackie, Ian, Sanna, Giovanni, Knight, Jason, Zuo, Yu, Petri, Michelle, Leaf, Rebecca K., Roubey, Robert, Ortel, Thomas, Gonzalez, Emilio, Willis, Rohan, Kello, Nina, Belmont, Michael, Levine, Steven, Rand, Jacob, Barbhaiya, Medha, Erkan, Doruk, Salmon, Jane, Lockshin, Michael, Duarte Garcia, Ali A., and Branch, D. Ware

Abstract

Several antiphospholipid antibody (aPL) profiles (“triple” and lupus anticoagulant [LA] positivity) are associated with a higher risk for clinical manifestations of antiphospholipid syndrome (APS). Further risk is correlated with higher levels of anticardiolipin antibody (aCL) and anti-β2glycoprotein-I antibody (aβ2GPI), and with aPL persistence. Given that the 3 aPL tests detect partially overlapping sets of antibodies, the primary goal of this study was to characterize the associations among aPL tests using AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) core laboratory data. The APS ACTION Registry includes annually followed adult patients with positive aPL based on the Revised Sapporo Classification Criteria. We analyzed baseline and prospective core laboratory data of the registry for associations among aPL tests using the Spearman rank correlation with Bonferroni-adjusted significance level for multiple comparisons. An aPL Load was calculated based on 6 tests (aCL IgG/IgM/IgA and aβ2GPI IgG/IgM/IgA); a receiver operating characteristic curve was used to evaluate the diagnostic performance of the aPL Load in predicting LA positivity. In 351 patients simultaneously tested for LA, aCL, and aβ2GPI, the frequency of moderate-to-high (≥40 U) titers of aCL and aβ2GPI IgG/IgM/IgA was higher in patients who were positive for LA vs those who were negative. An aPL Load was calculated for each patient to assess the overall aPL burden. For every 1-point increase in the aPL Load, the possibility of a positive LA test increased by 32% (odds ratio, 1.32; 95% CI, 1.2-1.5; P< .001). Based on core laboratory data from a large international registry, most aPL enzyme-linked immunosorbent assay ≥40 U and a high calculated aPL Load combining 6 aPL enzyme-linked immunosorbent assays were predictive of a positive LA. These data suggest that the combined quantitative burden of aPL may provide a mechanistic explanation of a positive LA.

Published
2023
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