Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Nov 2024
ReviewHow to treat patients with thrombotic antiphospholipid syndrome in 2024?
Antiphospholipid syndrome (APS) encompasses a range of clinical conditions, particularly thrombotic or obstetrical manifestations, associated with the presence of antiphospholipid antibodies. Managing thrombotic APS in daily clinical practice can be challenging and requires thorough risk stratification and tailored treatment strategies. Primary prophylaxis focuses on correcting the traditional thrombotic risk factors and, in certain situations, may include low‑dose aspirin and / or prophylactic anticoagulants (eg, low‑molecular‑weight heparin). ⋯ In some cases, a combination of VKAs and low‑dose aspirin, increased doses of VKAs with an international normalized ratio target greater than 3, or a switch to therapeutic doses of low‑molecular‑weight heparin might be employed. The use of hydroxychloroquine is essential in patients with secondary systemic lupus erythematosus and may be considered in individuals with recurrent thrombosis. In other selected situations, the use of immunomodulatory agents can be considered.
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Pol. Arch. Med. Wewn. · Nov 2024
ReviewChallenges in laboratory testing of patients suspected of antiphospholipid syndrome: practical implications for clinicians.
This paper focuses on laboratory tests necessary for a diagnosis of antiphospholipid syndrome (APS). The diagnosis starts with a selection of patients suspected of APS. Timing related to a clinical event is important to avoid false classification of APS patients. ⋯ Laboratory diagnosis of APS remains challenging. To increase the diagnostic efficacy and reliability, an integrated interpretation of all results and an interpretative comment should be provided on the laboratory report. Therefore, a close interaction between clinical pathologists and clinicians is mandatory.
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Pol. Arch. Med. Wewn. · Nov 2024
Rare transthyretin gene variants (p.Ala45Thr, p.Val91Ala, p.Phe53Cys, p.Ala101Val, p.Glu109Lys and p.Phe53Leu): diagnostic pitfalls and clinical characteristics of Polish patients with transthyretin cardiac amyloidosis.
The knowledge about clinical features of Polish patients with hereditary type of transthyretin cardiac amyloidosis (hATTR-CA) is scant. ⋯ This study broadens our knowledge regarding genotype‑phenotype correlations of specific TTR variants, widens the spectrum of identified TTR variants in the Polish population, and shows limited value of [99mTc]Tc‑DPD scintigraphy in some patients with hATTR‑CA. In the cases with strong suspicion of ATTR‑CA and inconclusive [99mTc]Tc‑DPD scintigraphy results, genetic testing should be considered.
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Pol. Arch. Med. Wewn. · Nov 2024
Mpox outbreak among men who have sex with men in Kraków, Poland; June 2022-November 2022.
Mpox is a zoonotic disease caused by mpox virus. Sporadic cases reported before 2022 were almost universally linked to a direct contact with animals or travel to endemic regions of Africa. However, in 2022, a significant shift occurred in human‑to‑human transmission, leading to a global outbreak in 117 countries. In Poland, 217 cases of mpox were reported. ⋯ The 2022 mpox outbreak in Kraków primarily affected MSM and was transmitted through sexual contact. Health care professionals should be aware of emerging STIs. Educational initiatives should emphasize the importance of vaccinations, safe sexual practices, and regular testing.