Antiphospholipid Syndrome (APS / APL)
Antiphospholipid Syndrome (APS for
short) is an autoimmune of the blood that causes blood
clots to form in both the veins and arteries (known
as thrombosis), and can cause serious complications.
The blood clots can form anywhere in the body, but
most commonly in the legs, kidneys and lungs. Any
tissue, organ or part of the body can be affected.
APS can be a primary condition or can be a secondary
condition to another disorder, disease or condition
such as Lupus. Some of the symptoms of APS include
a purplish lace-like pattern of veins appearing through
the skin (livedo reticularis), headaches and migraines.
APS can also cause serious complications with pregnancy,
and may not even present until pregnancy. Some of
the pregnancy related complications include miscarriage,
stillbirth, pre-term delivery and severe preeclampsia.
Some studies have also linked APS with the pregnancy
complication called HELLP Syndrome as a trigger for
APS.
There is no cure for APS, but treatment to control
the symptoms and clotting is available.
Symptoms:
Blood clots in legs
Blood clots in lungs
Blotchy, bluish rash that looks like lace that does
not go away (livedo reticularis)
Chest pain
Difficulty concentrating
Dizziness
Memory loss
Multiple miscarriages
Partial blindness
Pregnancy complications such as preeclampsia., eclampsia
and premature delivery
Seizures
Skin lesions on the legs
Total vision loss
Ulcers on the feet
Unsteady balance and clumsiness
Vertigo
Diagnosis:
In many cases, APS is diagnosed after a form of vascular
thrombosis or other significant vascular event is
diagnosed. A common practice for diagnosing APS is
the use of the Sapporo APS Classification Criteria.
The criteria for an APS diagnosis requires the following:
a) Blood clots (Vascular Thrombosis) in any organ
or tissue, or a Pregnancy Event (one or more miscarriages
after 10th week of gestation, three or more miscarriages
before 10th week of gestation, or one or more premature
births before 34th week of gestation due to eclampsia)
b) A persistently Positive aPL (lupus anticoagulant
test, moderate-to-high titer anticardiolipin antibodies,
or moderate-to-high titer ß2-glycoprotein-I
antibodies), tested at least 6 weeks apart
For a catastrophic APS diagnosis, the most common
criteria used is The International Consensus Statement.
A definite diagnosis requires:
a) Blood clots (Vascular Thrombosis) in three or
more organs or tissues and
b) Development of manifestations simultaneously or
in less than a week 'and
c) Evidence of small vessel thrombosis in at least
one organ or tissue and
d) Laboratory confirmation of the presence of aPL.
Blood Tests may also show:
Elevated Anticardiolipin Antibodies (ACA)
Positive Lupus Anticoagulant Antibody (LA)
Low Platelet Count (Plt)
Elevated ß2-Glycoprotein 1 Antibody
Treatment:
APS is treated with anti-coagulants (anti-clotting)
medications such as Warfarin. Aspirin used long-term
can also reduce platelet activation.
Prognosis:
With effective treatment, most people suffering from
APS respond well and can live full, normal lives.
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