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3. Makulablutung durch Musizieren

Author

Kaskel-Paul, S

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund Eine 23-jährige Frau stellt sich wegen einer akuten Sehverschlechterung am linken Auge auf 1/15 Metervisus notfallmäßig vor. Die klinische Untersuchung zeigt eine Makulablutung. Die Vorgeschichte ist leer. Lediglich wurde in den Tagen zuvor intensiv auf einem Holzblasinstrument[zum vollständigen Text gelangen Sie über die oben angegebene URL], 181. Versammlung des Vereins Rheinisch-Westfälischer Augenärzte

Published
2019
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4. 3-year results of the German nationwide survey on eye injuries caused by fireworks

Author

Gabel-Pfisterer, A., Boehringer, D., Agostini, H., Fuest, M., Walter, P., Botros, Y., Mueller, A., Al-Ashi, N., Lenglinger, M., Mueller, B., Schoenfeld, S., Seibel, I., Joussen, A., Breuss, H., Kuchenbecker, J., Foerster, M. H., Berthold, A., Wirbelauer, C., Hofmayer, H., Wachtlin, J., Palka, K., Niemeyer, M., Walla, T., Pham, D., Aisenbrey, S., Tatsiou, A., Walch, A., Burk, R., Schultz, T., Tsiampalis, N., Rehmann, J., Sliwowska, U., Schojai, M., Schulze, K., Kamguia, N., Wirtz, C., Dick, B., Voelker, D., Wintergerst, M., Pfau, M., Melzer, C., Hoegen, D., Bosch, F., Andresen, J. C., Krohne, T., Holz, F., Kathke, M., Sturm, A., Noske, W., Huebner, T., Brandner, S., Feldmann, M., Morsek, J., Rainer, O., Bartsch, H., Ewald, K., Chankiewitz, E., Siegmund, T., Bohlen, A., Mohr, A., Hecker, J., Strassburger, P., Furashova, O., Engelmann, K., Krieb, A., Emmerich, K., Grajewski, L., Krause, L., Jabur, A., Ruediger, K., Lehmann, F., Sachs, H., Matthee, E., Steindorf, F., Schnitzler, C., Neumann, I., Korbmacher, J., Geerling, G., Doulgkeridis, J., Erhard, J., Dahms-Dowidat, K., Kotiasvili, T., Jagow, B. V., Lieder, A., Blum, M., Westerkemper, H., Boehm, M., Bornfeld, N., Bechrakis, N., Schultheiss, M., Scheider, A., Mueller, M., Kohnen, T., Eckert, T., Eckardt, C., Wisniewska, M., Just, A., Jehle, V., Reinhard, T., Seewald, J., Mais, C., Basiakos, S., Osman, B., Xanthopoulou, E., Friedburg, B., Graef, M., Lorenz, B., Just, U., Naxer, S., Oterendorp, C., Bemme, S., Callizo, J., Feltgen, N., Hoerauf, H., Menges, A., Tost, F., Stahl, A., Huth, A., Viestenz, A., Bertram, P., Skevas, C., Kromer, R., Casagrande, M., Grohmann, C., Mehlan, J., Schindler, P., Spitzer, M., Schargus, M., Eddy, M., Schumacher, S., Keserue, M., Scheler, A., Stemplewitz, B., Schaudig, U., Abou Moulig, W., Framme, C., Rosenthal, A., Hesse, L., Kunz, L., Spira, C., Suffo, S., Seitz, B., Wietstock, G., Augsten, R., Meller, D., Mayer, M., Vanselow, K., Lieb, W., Beutner, A., Effert, R., Ehlken, C., Roider, J., Hueber, A., Cursiefen, K., Schrage, N., Kroeger, M., Viehweg, N., Meier, P., Unterlauft, J. D., Wiedemann, P., Hattenbach, L., Kakkassery, V., Ranjbar, M., Mohi, A., Grisanti, S., Bastron, I., Sarac, S., Kaskel-Paul, S., Stoffelns, B., Schuster, A., Pfeiffer, N., Schulze, S., Praskevas, A., Sekundo, W., Weigel, M., Thieme, H., Wolf, A., Vounotrypidis, E., Priglinger, S., Bechstein, L., Maier, M., Lohmann, C., Haritoglu, C., Alten, F., Eter, N., Klishko, V., Holland, U., Medra, A., Weber, A., Hoeh, H., Schmidbauer, J., RiveraGomez, C., Plantzas, K., Weiss, M., Hille, K., Hoehn, F., Schrader, M., Napholz, A., Tandogan, T., Walter, C., Zuehlsdorff-Uthke, M., Liekfeld, A., Blecha, C., Barth, T., Helbig, H., Juenemann, A., Decker, A., Kuehn, M., Ladewig, M., Lenhard, K., Lackner, B., Gekeler, F., Holzschuh, I., Boden, K. T., Szurmann, P., Faul, D., May-Endres, K., Press, U., Luttke, J., Ziemssen, F., Bartz-Schmidt, U., Cordes, J., Raber, F., Mikielewicz, M., Kammerer, J., Kupferschmid, S., Buchwald, H., Werner, J., Kampmeier, J., Bula, A., Krauss, P., Strzalkowski, P., Hillenkamp, J., Gabel-Pfisterer, A., Boehringer, D., Agostini, H., Fuest, M., Walter, P., Botros, Y., Mueller, A., Al-Ashi, N., Lenglinger, M., Mueller, B., Schoenfeld, S., Seibel, I., Joussen, A., Breuss, H., Kuchenbecker, J., Foerster, M. H., Berthold, A., Wirbelauer, C., Hofmayer, H., Wachtlin, J., Palka, K., Niemeyer, M., Walla, T., Pham, D., Aisenbrey, S., Tatsiou, A., Walch, A., Burk, R., Schultz, T., Tsiampalis, N., Rehmann, J., Sliwowska, U., Schojai, M., Schulze, K., Kamguia, N., Wirtz, C., Dick, B., Voelker, D., Wintergerst, M., Pfau, M., Melzer, C., Hoegen, D., Bosch, F., Andresen, J. C., Krohne, T., Holz, F., Kathke, M., Sturm, A., Noske, W., Huebner, T., Brandner, S., Feldmann, M., Morsek, J., Rainer, O., Bartsch, H., Ewald, K., Chankiewitz, E., Siegmund, T., Bohlen, A., Mohr, A., Hecker, J., Strassburger, P., Furashova, O., Engelmann, K., Krieb, A., Emmerich, K., Grajewski, L., Krause, L., Jabur, A., Ruediger, K., Lehmann, F., Sachs, H., Matthee, E., Steindorf, F., Schnitzler, C., Neumann, I., Korbmacher, J., Geerling, G., Doulgkeridis, J., Erhard, J., Dahms-Dowidat, K., Kotiasvili, T., Jagow, B. V., Lieder, A., Blum, M., Westerkemper, H., Boehm, M., Bornfeld, N., Bechrakis, N., Schultheiss, M., Scheider, A., Mueller, M., Kohnen, T., Eckert, T., Eckardt, C., Wisniewska, M., Just, A., Jehle, V., Reinhard, T., Seewald, J., Mais, C., Basiakos, S., Osman, B., Xanthopoulou, E., Friedburg, B., Graef, M., Lorenz, B., Just, U., Naxer, S., Oterendorp, C., Bemme, S., Callizo, J., Feltgen, N., Hoerauf, H., Menges, A., Tost, F., Stahl, A., Huth, A., Viestenz, A., Bertram, P., Skevas, C., Kromer, R., Casagrande, M., Grohmann, C., Mehlan, J., Schindler, P., Spitzer, M., Schargus, M., Eddy, M., Schumacher, S., Keserue, M., Scheler, A., Stemplewitz, B., Schaudig, U., Abou Moulig, W., Framme, C., Rosenthal, A., Hesse, L., Kunz, L., Spira, C., Suffo, S., Seitz, B., Wietstock, G., Augsten, R., Meller, D., Mayer, M., Vanselow, K., Lieb, W., Beutner, A., Effert, R., Ehlken, C., Roider, J., Hueber, A., Cursiefen, K., Schrage, N., Kroeger, M., Viehweg, N., Meier, P., Unterlauft, J. D., Wiedemann, P., Hattenbach, L., Kakkassery, V., Ranjbar, M., Mohi, A., Grisanti, S., Bastron, I., Sarac, S., Kaskel-Paul, S., Stoffelns, B., Schuster, A., Pfeiffer, N., Schulze, S., Praskevas, A., Sekundo, W., Weigel, M., Thieme, H., Wolf, A., Vounotrypidis, E., Priglinger, S., Bechstein, L., Maier, M., Lohmann, C., Haritoglu, C., Alten, F., Eter, N., Klishko, V., Holland, U., Medra, A., Weber, A., Hoeh, H., Schmidbauer, J., RiveraGomez, C., Plantzas, K., Weiss, M., Hille, K., Hoehn, F., Schrader, M., Napholz, A., Tandogan, T., Walter, C., Zuehlsdorff-Uthke, M., Liekfeld, A., Blecha, C., Barth, T., Helbig, H., Juenemann, A., Decker, A., Kuehn, M., Ladewig, M., Lenhard, K., Lackner, B., Gekeler, F., Holzschuh, I., Boden, K. T., Szurmann, P., Faul, D., May-Endres, K., Press, U., Luttke, J., Ziemssen, F., Bartz-Schmidt, U., Cordes, J., Raber, F., Mikielewicz, M., Kammerer, J., Kupferschmid, S., Buchwald, H., Werner, J., Kampmeier, J., Bula, A., Krauss, P., Strzalkowski, P., and Hillenkamp, J.

Abstract

Background On festive days worldwide eyes are severely injured by fireworks. The data on the number and severity are to date not registered in Germany. Objective How frequent are firework-induced injuries in Germany, who are the affected, how serious are the injuries, which forms of treatment are necessary and how frequent are accompanying injuries? Method A German nationwide online-based survey was carried out in all inpatient eye departments and data over the last 3 consecutive years were descriptively analyzed. Results From New Years Eve 2016/2017, when 41 eye departments sent in data, the participation could be increased to 51 eye departments in 2018/2019. More than one third (33-39%) of all 1356 patients over 3 years were minors, 60% were younger than 25 years old and roughly 60% of patients were injured as bystanders or in an unclear situation. In total 25% of all eye injuries were considered severe and required inpatient treatment. Accompanying injuries of the other eye, the face and hands were more frequent in minors than in adults. Eyeball ruptures were reported in 10 minors and 38 adults over the 3 years. Conclusion Particularly minors and bystanders need better protection.

Published
2019

6. Gestielter Bindehauttumor

Author

Kaskel-Paul S, Caspar I, Herbst E, and Höh H

Subjects
Ophthalmology, Pathology, medicine.medical_specialty, business.industry, Kidney Carcinoma, Medicine, Conjunctival Tumor, business, Clear cell
Published
2007

7. Kanaloplastik – Erste Erfahrungen an der Lüdenscheider Augenklinik

Author

García Velasco, MJ and Kaskel-Paul, S

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: Die Kanaloplastik (KP) wird als Alternative zur Goniotrepanation bzw. Trabekulektomie angewandt, um den intraokularen Druck (IOD) bei Glaukompatienten zu senken. Wir berichten über eigene Erfahrungen und Ergebnisse bei der Etablierung des Verfahrens. Methoden: Ausgewertet wurden[for full text, please go to the a.m. URL], 175. Versammlung des Vereins Rheinisch-Westfälischer Augenärzte

Published
2013
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11. Pandemiebedingtes Verkaufsverbot von Feuerwerkskörpern in Deutschland führt zu einer deutlichen Abnahme der Augenverletzungen

Author

Gabel-Pfisterer, Ameli, Böhringer, Daniel, Agostini, Hansjürgen, Feuerwerks-Verletzungen-Studiengruppe, Botros, Y., Krieb, A., Emmerich, K.-H., Grajewski, L., Krause, L., Hoa, D. Q., Yilmaz, S., Jabur, A., Rüdiger, K., Boeker, T., Rashitova, D., Eberlein, G., Lehmann, F., Sachs, H., Matthee, E., Pillunat, L., Juergens, L., Kaya, S., Guthoff, R., Steindorf, F., Korbmacher, J., Geerling, G., Märtz, J., Widder, R., Rössler, G., Iseed, A., Doulgkeridis, J., Erhard, J., Tomalla, M., von Jagow, B., Filev, F., Schill, S., Kotiasvili, T., Kojetinski, C., Flach, A., Zollfrank, C., Lieder, A., Blum, M., Tourtas, T., Knorr, H., Kruse, F., Freimuth, M., Dalbah, S., Sokolenko, E., Mueller, A., Rating, P., Kiefer, T., Book, B., Westerkemper, H., Böhm, M., Bornfeld, N., Bechrakis, N., Schultheiss, M., Scheider, A., Pawlowczicz, K., Hagenbusch, J., Müller, M., Kohnen, T., Ahdab, K., Eckert, T., Eckardt, C., Wisniewska, M., Just, A., Laich, Y., Stifter, J., Avar, M., Gritzka, M., Jehle, V., Reinhard, T., Rab, S., Seewald, J., Mais, C., Basiakos, S., Osman, B., Xanthopoulou, E., Friedburg, B., Graef, M. H., Dempe, C., Lorenz, B., Just, U., Schrecker, J., Klemming, J., Drüke, D., Bemmer, L., Weiß, S., Take, P., Nguyen-Höhl, A., Oterendorp, C., Al-Ashi, N., Feltgen, N., Hoerauf, H., Prusiecki, I., Elle, J., Gundel, B., Bender, M. C., Menges, A., Tost, F., Stahl, A., Wienrich, R., Breuß, H., Huth, A., Viestenz, A., Ueberschaar, J., Daehn, T., Brooks, U., Schindler, P., Bigdon, E., Bertram, P., Skevas, C., Kromer, R., Kuchenbecker, J., Casagrande, M., Grohmann, C., Mehlan, J., Spitzer, M., Schargus, M., Eddy, M., Schumacher, S., Keserü, M., Scheler, A., Foerster, M. H., Stemplewitz, B., Schaudig, U., Herden, J., Haar, M., Tode, B., Junker, B., Abou Mouli, W., Volkmann, I., Framme, C., Scheuerle, A., Seibel, I., Auerbach, M., Beisse, C., Rohrschneider, K., Auffahrt, G., Mala, N., Rosenthal, A., Hesse, L., Daas, L., Flockerzie, E., Suffo, S., Böker, A., Seitz, B., Chrisoglou, N., Wietstock, G., Augsten, R., Meller, D., Althauspetervari, I., Rudolph, O., Floeter, C., Beutner, A., Effert, R., Greve, D., Mayer, M., Vanselow, K., Lieb, W., Kandzia, C., Purtskhvanidze, K., Ehlken, C., Roider, J., Hueber, A., Cursiefen, K., Edelmann, C., Lenglinger, M., Schrage, N., Kroeger, M., Viehweg, N., Meier, P., Unterlauft, J. D., Wiedemann, P., Rehak, M., Ziemssen, F., Rommel, F., Sonntag, S., Müller, B., Prasuhn, M., Pawlik, V., Kakkassery, V., Ranjbar, M., Mohi, A., Grisanti, S., Bastron, I., Dindin-Sarac, S., Kaskel-Paul, S., Rawohl, J., Schönfeld, S., Hattenbach, L., Stoffelns, B., Schuster, A., Pfeiffer, N., Besgen, V., Schröder, F., Schulze, S., Weber, N., Sekundo, W., Schuart, C., Renieri, G., Weigel, M., Thieme, H., Hagenau, F., Wolf, A., Vounotrypidis, E., Priglinger, S., Penkava, J., Klein, J., Bechstein, L., Joussen, A., Maier, M., Lohmann, C., Haritoglu, C., Alten, F., Eter, N., Brinkmann, C., Alshikh, F., Klishko, V., Holland, U., Medra, A., Kolarov, D., Weber, A., Höh, H., Pielen, A., Zschockelt, T., Luciani, F., Schmidbauer, J., Horn, P., Kodomskoi, L., Kuempel, H., Schwarz, P., Rivera Gomez, C., Plantzas, K., Weiss, M., Hille, K., Esper, G., Mazko, K., Kolbeck, L., Malek, S., Kupper, P., Grafmueller, S., Puk, C., Schrader, S., Darawsha, R., Bellios, N., Wulff, V., Ghaffary, A., Ghoreishi, A., Höhn, F., Napholz, A., Tandogan, T., Schmidt, L., Berthold, A., Ilski, P., Trossowski, C., Zühlsdorff-Utke, M., Liekfeld, A., Winter, I., Böhm, A., Blecha, C., Barth, T., Helbig, H., Rusch, W., Wirbelauer, C., Noerenberg, A., Juenemann, A., Fuchsluger, T. A., Matar, C., Zuche, M., Roehrig, S., Decker, A., Kühn, M., Ladewig, M., Schmidt-Wetter, J., Hofmayer, H., Machulla, R., Boateng, A.-F., Dias Blak, M., Krawczyk, S., Lenhard, K., Lackner, B., Gekeler, F., Mamacek, D., Wocker, L., Holzschuh, I., Wachtlin, J., Boden, K. T., Szurmann, P., Faul, D., May-Endres, K., Press, U., Luttke, J., Wolfram, L., Reichel, F., Seitz, I., Bartz-Schmidt, U., Speidel, A., Cordes, J., Raber, F., Mikielewicz, M., Kammerer, J., Kupferschmid, S., Buchwald, H., Werner, J., Meyer, J. F., Kampmeier, J., Dithmar, S., Fischer, G., Pruefke, C., Bula, A., Krauß, P., Strzalkowski, P., Hillenkamp, J., Macher, T., Kuerten, D., Palka, K., Niemeyer, M., Walla, T., Pham, D., Aisenbrey, S., Rieck, P., Verbeck, J., Tatsiou, A., Walch, A., Burk, R., Fuest, M., Schnober, G., Elling, M., Schultz, T., Tsiampalis, N., Rehmann, J., Sliwowska, U., Schojai, M., Schulze, K., Kamguia, N., Wirtz, C., Walter, P., Dick, B., Bourauel, L., Schützeichel, F. M., Völcker, D., Wintergerst, M., Pfau, M., Melzer, C., Hoegen, D., Bosch, F., Andresen, J. C., Wanjek-Meyer, K., Krohne, T., Holz, F. G., Fries, U., Koch, M., Kwasnicki, A., Kathke, M., Noske, W., Sturm, A., Chankiewitz, E., Monastoriotis, S., Kohen, L., Kemper, O., Hübner, T., Feldmann, M., Morsek, J., Rainer, O., Bartsch, H., Ewald, K., Brandter, S., Cil, M. U., Hartmann, K., Siegmund, T., Bohlen, A., Mohr, A., Wienigk, A., Hecker, J., Smetana, P., Furashova, O., Engelmann, K., Shtaya, M., and Müller, A.-K.

Abstract

Die Ophthalmologie 119(12), 1257-1266 (2022). doi:10.1007/s00347-022-01778-1, Published by Springer Medizin, Berlin ; Heidelberg

Published
2022

12. Retinal Vascular Occlusion after COVID-19 Vaccination: More Coincidence than Causal Relationship? Data from a Retrospective Multicentre Study.

Author

Feltgen N, Ach T, Ziemssen F, Quante CS, Gross O, Abdin AD, Aisenbrey S, Bartram MC, Blum M, Brockmann C, Dithmar S, Friedrichs W, Guthoff R, Hattenbach LO, Herrlinger KR, Kaskel-Paul S, Khoramnia R, Klaas JE, Krohne TU, Lommatzsch A, Lueken S, Maier M, Nassri L, Nguyen-Dang TA, Radeck V, Rau S, Roider J, Sandner D, Schmalenberger L, Schmidtmann I, Schubert F, Siegel H, Spitzer MS, Stahl A, Stingl JV, Treumer F, Viestenz A, Wachtlin J, Wolf A, Zimmermann J, Schargus M, and Schuster AK

Abstract

Background: To investigate whether vaccination against SARS-CoV-2 is associated with the onset of retinal vascular occlusive disease (RVOD)., Methods: In this multicentre study, data from patients with central and branch retinal vein occlusion (CRVO and BRVO), central and branch retinal artery occlusion (CRAO and BRAO), and anterior ischaemic optic neuropathy (AION) were retrospectively collected during a 2-month index period (1 June-31 July 2021) according to a defined protocol. The relation to any previous vaccination was documented for the consecutive case series. Numbers of RVOD and COVID-19 vaccination were investigated in a case-by-case analysis. A case-control study using age- and sex-matched controls from the general population (study participants from the Gutenberg Health Study) and an adjusted conditional logistic regression analysis was conducted., Results: Four hundred and twenty-one subjects presenting during the index period (61 days) were enrolled: one hundred and twenty-one patients with CRVO, seventy-five with BRVO, fifty-six with CRAO, sixty-five with BRAO, and one hundred and four with AION. Three hundred and thirty-two (78.9%) patients had been vaccinated before the onset of RVOD. The vaccines given were BNT162b2/BioNTech/Pfizer ( n = 221), followed by ChadOx1/AstraZeneca ( n = 57), mRNA-1273/Moderna ( n = 21), and Ad26.COV2.S/Johnson & Johnson ( n = 11; unknown n = 22). Our case-control analysis integrating population-based data from the GHS yielded no evidence of an increased risk after COVID-19 vaccination (OR = 0.93; 95% CI: 0.60-1.45, p = 0.75) in connection with a vaccination within a 4-week window., Conclusions: To date, there has been no evidence of any association between SARS-CoV-2 vaccination and a higher RVOD risk.

Published
2022
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13. [Current situation of allocation of academic medical personnel in ophthalmology departments in Germany].

Author

Schargus M, Wachtlin J, Aisenbrey S, Blum M, Framme C, Hattenbach LO, Hoerauf H, Kaskel-Paul S, and Geerling G

Subjects
Germany, Hospital Departments, Humans, Resource Allocation, Workforce, Ophthalmology
Abstract

Background: At present minimum nursing staff numbers have been defined and are being implemented. In December 2019 the German Medical Association asked the German professional associations about their general experience with planning of medical personnel in hospital departments. As no structured data were available on this subject, the German Ophthalmological Society (DOG) founded a working group in March 2020 to answer this request., Method: In the course of several consensus meetings, the working group on personnel planning for physicians in hospitals of the DOG prepared a questionnaire on previous experiences in personnel planning of eye hospitals, which was sent to the heads of all university eye hospitals and departments of ophthalmology in Germany. The questionnaire consisted of individual items with fixed choices and free answers regarding the procedure and current situation of staffing as well as the range of tasks and organization of the medical service., Results: Out of 104 departments 53 (51%) responded, of which 25 were from university departments (64% response), 23 from departments of other public or non-profit ownership (46%) and 5 from departments with private hospital ownership (33%). Of these 49% stated that there was no transparent basis for calculation of the number of medical positions in their hospital. Of the surveyed departments, outpatient tasks, services and revenues were considered in the calculations in only 47%. There was a statistically significant higher ratio of full-time personnel to the numbers of beds in university departments compared to private and publicly owned non-profit institutions (p < 0.001, t‑test). All departments have to cope with multiple additional tasks in addition to clinical patient care, which are taken into account only to a limited extent in the staffing. Approximately 70% of the departments provide a 24 h/7 day (24/7) medical on-call service on site, 91% have a 24/7 surgery on-call service and 34% have a cooperation with emergency services run by the Association of Statutory Health Insurance Physicians., Conclusion: The results show how heterogeneously and nontransparent German departments of ophthalmology are staffed in terms of medical doctors. On average, university departments have higher personnel resources per hospital bed to cope with additional tasks in research and teaching. Outpatient tasks, which contribute significantly to the revenues of an eye department, and multiple other tasks are often not taken into account in the personnel calculation. A transparent and uniform basis for calculation of the medical staff of the departments is desirable in order to achieve a sufficient personnel staffing for a patient and employee-oriented working environment.

Published
2020
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15. Autoantibodies to prothrombin and phosphatidylserine/prothrombin-complexes: do they contribute to the serodiagnosis of primary and secondary anti-phospholipid syndrome?

Author

Jaekel HP, Trabandt A, Schmid D, Grobe N, Müller EW, Ziutelis V, Kaskel-Paul S, Höh H, Bauer B, Sudik R, Baldauf A, and Werle E

Subjects
Adult, Aged, Antiphospholipid Syndrome diagnosis, Cross Reactions immunology, Female, Humans, Lupus Coagulation Inhibitor immunology, Male, Middle Aged, Serologic Tests, Antiphospholipid Syndrome immunology, Autoantibodies immunology, Phosphatidylserines immunology, Prothrombin immunology
Abstract

The diagnostic and clinical relevance of Ab to pure and phosphatidylserine-complexed prothrombin for primary and secondary APS was investigated in a total of 357 patients with (n = 169) and without (n = 188) connective tissue diseases. The overall frequency of anti-prothrombin Ab in sAPS, pAPS and patients without APS-related symptoms were found to be 50.0, 37.5 and 22.0%, respectively. From a total of 72 anti-prothrombin-positive samples, 12.5% were specific for pure prothrombin, 31.9% for phosphatidylserine/prothrombin-complexes and 55.6% recognized both antigenic forms. The simultaneous occurrence of other anti-phospholipid Ab was observed in 84% of all sera. Both types of anti-prothrombin Ab are significantly associated with lupus anticoagulant activity, but only Ab to pure prothrombin display such a relationship to clinical manifestations of APS. Based on these results, it cannot be recommended at present to include anti-prothrombin assays in the routine procedure for the serodiagnosis of APS. However, patients negative for lupus anticoagulant and typical APS-related anti-phospholipid Ab should be tested for anti-prothrombin reactivity, favoring, mainly due to its higher specificity, the ELISA containing pure prothrombin as antigen.

Published
2004

16. Reactivity profiles of autoantibodies to different phospholipids and the phospholipid-binding protein beta2-glycoprotein I in patients with clinical symptoms related to thromboembolic and/or vasculopathic events with or without connective tissue diseases.

Author

Jaekel HP, Schmid D, Müller EW, Ziutelis V, Trabandt A, Grobe N, Kaskel-Paul S, Höh H, Bauer B, Sudik R, Baldauf A, and Werle E

Subjects
Adult, Aged, Antibodies, Anticardiolipin immunology, Antiphospholipid Syndrome complications, Cardiolipins immunology, Connective Tissue Diseases complications, Cross Reactions, Female, Humans, Male, Middle Aged, Phosphatidylserines immunology, Pregnancy, Prospective Studies, Reproducibility of Results, Sensitivity and Specificity, Thromboembolism etiology, Vascular Diseases etiology, beta 2-Glycoprotein I, Antibodies, Antiphospholipid immunology, Antiphospholipid Syndrome immunology, Connective Tissue Diseases immunology, Glycoproteins immunology, Thromboembolism immunology, Vascular Diseases immunology
Abstract

To study the antigenic and epitope specificities of anti-phospholipid Ab in detail, we investigated 177 patients without (62 with APS-related systemic clinical symptoms, 115 with microangiopathies) and 164 patients with connective tissue diseases (CTD). Ab associated with primary APS (pAPS) seem to show a restricted specificity (phospholipid/beta2-GPI-complexes), whereas those in secondary APS (sAPS) react additionaly with pure beta2-GPI. Simultaneously, beta2-GPI-independent Ab were also frequently present in both conditions (50% of all Ab-positive sera). In CTD patients, the reactivity profile "pure beta2-GPI + phospholipid/beta2-GPI-complexes" is significantly associated with clinically manifest sAPS. Comparing cardiolipin and phosphatidylserine as antigenic target, the overall concordance (crossreactivity?) between both assays was lower than expected (52%), being highest in pAPS (87%) and sAPS (65%). Based on these results, a two-step procedure for reliable serological diagnosis of APS could be recommended: Ab-screening using a mix of phospholipids complexed with beta2-GPI (sensitivity > 90% for Ab concentrations above 20 U/ml) followed by an assay allowing the simultaneous detection of all relevant antigenic and epitope specificities.

Published
2003

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