Antiphospholipid Syndrome Flashcards
What is APS?
Disorder associated with antiphospholipid antibodies where blood becomes prone to clotting
-Can be primary or secondary
What are the symptoms?
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
What are the investigations?
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
How is it diagnosed?
2 high anticardiolipin antibodies on 2 separate titres 12 weeks apart
History of thrombosis or pregnancy complications
What is the management?
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