Anti-Phospholipid Syndrome

Question 1

What is anit-phospholipid syndrome (ASP)

Answer 1

A disorder than manifests clinically as recurrent venous or arterial thrombosis and/or fetal loss

Question 2

How does anti-phospholipid syndrome present?

Answer 2

Increased frequently of stroke or MI esp. in younger patients
In situ thrombosis or embolization
Endocarditis
Life-threatening pulmonary hypertension from recurrent pulmonary emboli or thrombosis
Late spontaneous fetal loss (2nd or 3rd trimester)
Recurrent fetal loss (less than 10 weeks gestation)
Migraine
Livedo redicularis

Question 3

What is catastrophic CAPS

Answer 3

A rare, serious, and often fatal manifestation of APS. 50% mortality rate.
Multiorgan infarctions over a period of days to weeks.

Question 4

APS investigations

Answer 4

Thrombocytopenia and prolongation of APTT
Lupus anticoagulant, anti-cardiolipin antibody positive
Anti-beta 2 glycoprotein positive

Question 5

Management of APS

Answer 5

Anti-coagulation for those with episodes of thrombosis
Recurrent pregnancy loss –> LMWH as warfarin is teratogenic
Patients with positive antibodies but no thrombosis do not require anti-coagulation