Antiphospholipid Syndrome Flashcards

1
Q

What is APS?

A

Disorder associated with antiphospholipid antibodies where blood becomes prone to clotting

-Can be primary or secondary

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2
Q

What are the symptoms?

A

VTE

  • DVT= red, hot, swollen leg
  • PE= SoB, chest pain, cough/coughing up blood

Arterial thrombosis

  • less common
  • stroke
  • MI
  • Renal thrombosis

Pregnancy complications

  • recurrent miscarriage
  • stillbirth
  • PET

Livedo reticularis
-purple lace like rash

Libmann Sacks endocarditis

  • non bacterial endocarditis
  • growths of valves on heart

Thrombocytopenia
Migraines
Epilepsy

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3
Q

What are the investigations?

A

ESR-normal
ANA-negative
APTT- increased (thrombosis risk still high)

Coombs test positive

Anticardiolipin antibodies- diagnostic

Lupus anticoagulant antibodies

  • present in 20%
  • increased risk of thrombosis
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4
Q

How is it diagnosed?

A

2 high anticardiolipin antibodies on 2 separate titres 12 weeks apart

History of thrombosis or pregnancy complications

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5
Q

What is the management?

A

MDT involvement
Long term warfarin
-INR target 2-3 to prevent thrombosis
-INR target 3-4 if recurrent thrombosis

LMWH
-if pregnant plus aspirin to reduce risk of complications

No thrombotic history

  • low dose aspirin
  • lifestyle advice- do not sit still for long periods of time

Long term prognosis poor with 1/3 having organ damage within 10 years

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