Antiphospholipid Syndrome

Question 1

What is antiphospholipid syndrome?

Answer 1

A disorder characterised by a predisposition to venous and arterial thrombosis

Can be a primary disorder or secondary to SLE

Autoimmune disease with antibodies against phospholipids

Question 2

What are some of the features of antiphospholipid syndrome?

Answer 2

Coagulation defects
Livedo reticularis
Obstetric complications (e.g. recurrent miscarriage)
Thrombocytopenia (Low platelets)

Question 3

What antibody is indicated in antiphospholipid syndrome related to SLE?

Answer 3

Anti-cardiolipin

Also called lupus anti-coagulation

These are also positive in syphilis so causes a false positive in syphilis testing.

Question 4

What is prolonged on clotting times for antiphospholipid syndrome?

Answer 4

APTT

This is misleading as it causes clotting in-vivo

Question 5

What is the management of antiphospholipid syndrome?

Answer 5

Reduce clotting risk

Warfarin- Target 2-3 or if recurrent VTE whilst on warfarin up to 3-4

Question 6

What skin sign is seen in antiphospholipid syndrome?

Answer 6

Livedo reticularis

Kind of looks like mottled skin due to venules being obstructed by clots

Question 7

What mnemonic can help to remember the features of antiphospholipid syndrome?

Answer 7

CLOTS

Coagulation
Livedo reticularis
Obstetric complication
Thrombocytopenia

Question 8

What is the most common antibody causing antiphospholipid syndrome?

Answer 8

Anti- Beta 2 Glycoprotein 1

Question 9

What obstetric complications are seen in antiphospholipid syndrome?

Answer 9

Recurrent miscarriages

Question 10

Can warfarin be used in pregnancy?

Answer 10

No absolutely not

LMWH can though