Antiphospholipid Antibody Syndrome

Question 1

What are the antiphospholipid antibodies?

Answer 1

Lupus anticoagulant- most common, prolongs the aPTT
Anticardiolipin antibodies
Beta 2 glycoprotein 1

Question 2

Does warfarin correct PT?

Answer 2

Yes because it affects the coagulation cascade

Question 3

Does heparin correct the aPTT?

Answer 3

No it doesn’t

Question 4

How to diagnose antiphospholipid syndrome?

Answer 4

Requires one clinical criteria and

One lab criteria

Question 5

What are the clinical criteria?

Answer 5

Vascular thrombosis

Pregnancy morbidity

Question 6

What are the Laboratory criteria?

Answer 6

Raised IgG or IgM anticardiolipin or
Raised anti beta 2 glycoprotein 1 or
Raised lupus anticoagulant
On @ least 2 occasions and @ least 12 weeks apart

Question 7

How to treat APS?

Answer 7

Anticoagulation: warfarin most common CI in pregnancy

Antibody depletion: only in catastrophic APS, cyclophosphamide,IVIG

Question 8

What are the secondary prevention measures?

Answer 8

Perioperative prophylaxis management (3-9 points on Caprini score)
Smoking cessation 
Pregnancy management (heparinoids, aspirin if no prior antibodies nor thrombosis)