Antiphospholipid syndrome Flashcards
What type of condition is antiphospholipid syndrome?
Autoimmune disorder
What is antihospholipid syndrome characterised b?
Arterial and venous thrombosis
Recurrent fetal loss
Thrombocytopenia (low platelet count)
How can antiphospholipid syndrome occur?
As a primary disorder or secondary to other conditions
What condition can antiphospholipid syndrome occur secondary to?
SLE
What are the main features of Antiphospholipid syndrome?
Clots
Livedo reticularis
Obstetric loss
Thrombocytopenia
What is the pheumonic for the main features of antiphospholipid syndrome?
CLOT
What does clots include?
Venous thromboembolism- DVT and PE
Arterial embolism- Myocardial infarction or stroke
What is livedo reticularis?
A mottled, lace-like appearance of the skin on the lower limbs.
What obstetric loss can antiphospholipid syndrome result in?
Recurrent miscarriages
Pre-eclampsia
Premature births can occur.
What is a characteristic sign of antiphospholipid syndrome?
Prolonged APTT
(PARADOXICAL RISE)
What is the management of antiphospholipid syndrome?
primary thromboprophylaxis: low-dose aspirin
What is secondary thromboprophylaxis for initial VTE events in the management of antiphospholipid syndrome?
Lifelong warfarin with a target INR of 2-3
What is secondary thromboprophylaxis for recurrent VTE events in the management of antiphospholipid syndrome?
Lifelong warfarin
If occurred whilst taking warfarin then consider adding low-dose aspirin, increase target INR to 3-4
What is secondary thromboprophylaxis for arterial thrombosis in the management of antiphospholipid syndrome?
Arterial thrombosis should be treated with lifelong warfarin with target INR 2-3
What is needed to diagnose antiphospholipid syndrome?
Positive blood tests are needed on 2 occasions, 12-weeks
What do the blood tests need to show for the diagnosis of antiphospholipid syndrome?
Anti-cardiolipin antibodies.
Anti-beta2-GPI antibodies.
Positive lupus anticoagulant assay.
What is the problem of using warfrain during pregnancy?
It is teratogenic
What medication can be used as an alternative during pregnancy for antiphospholipid syndrome?
Low molecular weight heparin.
How can the risk of VTE be reuced in someone with Antiphospolipid syndrome?
Avoid oestrogen-containing contraception / hormone replacement therapy and long periods of immobility.
How can the risk of arterial thrombosis be reuced in someone with Antiphospolipid syndrome?
Control cardiovascular risk factors (eg. smoking, blood pressure, cholesterol, blood glucose).
