Antifosfolipidové protilátky a jejich význam u tromboembolické nemoci

Abstract

The diagnostic workup in patients with venous thromboembolism (VTE) consists of imaging methods as well as laboratory assays and concentrates not only on diagnostic and follow-up procedures but also on the evaluation of the possible cause of VTE event. In the absence of an obvious clinical provoking factor, occult malignancy or thrombophilic disorder should be searched for. From the practical point of view, the most relevant are those thrombophilic states that are associated with an increased risk of recurrence and may therefore play a role in the decision about the length of the anticoagulation therapy (usually with warfarin) following the event. However, the most common inherited thrombophilic disorders are associated with only mildly increased risk of VTE recurrence and their detection does not usually warrant prolonged warfarin therapy. Antiphospholipid syndrome (APS) is an acquired thrombophilic state with a significantly higher risk of VTE recurrence, especially after warfarin withdrawal. The laboratory diagnostics of APS consists of coagulation assays (detection of lupus anticoagulans) as well as serologic tests of antiphospholipid antibodies (APA). APAs are very heterogeneous and only some of them are considered "diagnostic" - anticardiolipin antibodies (ACA) and newly also antibodies...

1 UNIVERZITA KARLOVA V PRAZE LÉKAŘSKÁ FAKULTA V PLZNI Autoreferát disertační práce Antifosfolipidové protilátky a jejich význam u tromboembolické nemoci Plzeň 2009 2 Doktorský studijní program na Lékařské fakultě Univerzity Karlovy v Plzni Forma studia: kombinovaná Obor: vnitřní nemoci Předseda komise pro obhajobu disertačních prací v oboru vnitřní nemoci: prof. MUDr. Ondřej Topolčan, CSc. Doktorand: MUDr. Jana Hirmerová Školitelé: Prof. MUDr. Jan Filipovský, CSc., II.interní klinika LF UK Plzeň Doc. MUDr. Zdenka Ulčová-Gallová, CSc., Gynekologicko-porodnická klinika LF UK Plzeň Pracoviště: II.interní klinika Lékařské fakulty University Karlovy a Fakultní nemocnice v Plzni Oponenti: Prof. MUDr. Jaroslav Malý, CSc. Lékařská fakulta Univerzity Karlovy v Hradci Králové, 2. interní klinika LFUK a FN v Hradci Králové MUDr. Karel Roztočil, CSc. Klinika kardiologie IKEM, Praha 3 Autoreferát byl rozeslán dne .............. Obhajoba disertace před komisí pro obhajoby disertačních prací v oboru vnitřní lékařství se koná .................... Místo obhajoby: ...................................... S disertační prací je možno se seznámit na děkanátu LF UK v Plzni, Husova 3 4 Obsah Souhrn...............................................................................5...