S Lev

Publications (4)13.95 Total impact

• Article: Close association between valvar heart disease and central nervous system manifestations in the antiphospholipid syndrome.

  I Krause, S Lev, A Fraser, M Blank, M Lorber, L Stojanovich, J Rovensky, J Chapman, Y Shoenfeld
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  ABSTRACT: Heart valves lesions and central nervous system involvement are among the most common manifestations of the antiphospholipid syndrome (APS). To evaluate possible interrelations between these manifestations in a large group of APS patients. 284 APS patients were evaluated retrospectively, 159 of whom had primary APS. Cardiac-CNS associations were determined for the entire study population, and for subgroups of patients with primary APS or APS associated with systemic lupus erythematosus (SLE). Significant associations where found between cardiac vegetations and epilepsy (p < 0.02), and between cardiac valve thickening or dysfunction and migraine (p = 0.002). Borderline association was found between valvar vegetations and migraine (p = 0.09). A significant association was also found between all valvar lesions and stroke or transient ischaemic attacks. Subanalyses showed that patients with primary APS had significant associations between cardiac valve pathology and all CNS manifestations, while patients with APS associated with SLE had no such associations. The study suggests potential differences in biological behaviour between primary APS and APS associated with SLE. The presence of cardiac valve pathology may be a risk factor for several types of CNS involvement in PAPS.
  Annals of the Rheumatic Diseases 10/2005; 64(10):1490-3. · 8.73 Impact Factor
• Article: Prevalence and clinical correlations of antibodies against six beta2-glycoprotein-I-related peptides in the antiphospholipid syndrome.

  Y Shoenfeld, I Krause, F Kvapil, J Sulkes, S Lev, P von Landenberg, J Font, J Zaech, R Cervera, J C Piette, [......], A Jönsen, T Koike, M Sanmarco, A Ruffatti, Z Ulcova-Gallova, S Praprotnik, B Rozman, M Lorber, V B Vriezman, M Blank
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  ABSTRACT: Two-hundred ninety five patients with the antiphospholipid syndrome (APS) were studied for the presence of antibodies against six anti-beta2GPI-related peptides Abs. The prevalence of a wide spectrum of clinical and laboratory parameters of APS was evaluated in all patients, and correlated with the presence of each anti-beta2GPI peptide antibody. The rates of the various antipeptides Abs ranged from 18.0 to 63.7%. Altogether, 87.1% of the patients had antibody reactivity against at least one of the six beta2GPI-related peptides. A high degree of simultaneous reactivity against several beta2GPI-peptides was found. Positive and negative correlations were found between several antipeptides Abs and the rates of thrombosis and fetal loss. Our results point to a heterogeneous activity of antiphospholipid Abs in APS patients, directed, often concurrently, against various epitopes of the beta2GPI molecule. Evaluation of APS patients for the presence of specific antipeptides Abs may be of a value in predicting the risk for future thrombotic and obstetrical complication, as well as for specific therapeutic purposes.
  Journal of Clinical Immunology 10/2003; 23(5):377-83. · 3.08 Impact Factor
• Article: Livedo reticularis is a marker for predicting multi-system thrombosis in antiphospholipid syndrome.

  E Toubi, I Krause, A Fraser, S Lev, L Stojanovich, J Rovensky, M Blank, Y Shoenfeld
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  ABSTRACT: Livedo reticularis (LR) is a skin vasculopathy that has been frequently described in patients with anti-phospholipid syndrome (APS) and reported to be present in association with valvular heart pathology and strokes (i.e. Sneddon's syndrome). In a cohort of APS patients we investigated the possible association of LR with various clinical aspects of APS such as pregnancy morbidity, central nervous system (CNS) and cardiac manifestations. Livedo reticularis was found in 50/308 (16%) of APS patients, and there was a significant association with cerebrovascular accidents (CVA), migraines and epilepsy (p = 0.01, 0.002, and 0.02 respectively). A similar association was also detected between LR, and the presence of cardiac valve thickening and vegetations (p = 0.001). No association with venous thrombosis, recurrent fetal loss, IUGR or toxemia was found. Livedo reticularis is a frequent cutaneous manifestation in patients with APS. Its high association with cardiac and CNS thrombosis may suggest that LR-APS patients compose a subset at higher risk for thrombosis, and thus may require a closer follow-up and a more aggressive anticoagulation.
  Clinical and experimental rheumatology 23(4):499-504. · 2.15 Impact Factor
• Source

  Available from: nih.gov

  Article: Close association between valvular heart disease and central nervous system manifestations in antiphospholipid syndrome

  I Krause, S Lev, A Fraser, M Blank, J Chapman, Y Shoenfeld