Antiphospholipid Syndrome

Question 1

Definition of antiphospholipid syndrome

Answer 1

• Disorder associated with antiphospholipid antibodies where blood becomes prone to clotting
• Patient in hyper-coagulable state
• Can occur secondary to autoimmune condition (i.e. SLE)
• Associated with antiphospholipid antibodies
  
  • Lupus antigcoagulant
  • Anticardiolipin antibodies
  • Anti-beta-2 glycoprotein I antibodies

Question 2

Associations with antiphospholipid syndrome

Answer 2

• VTE (DVT and PE)
• Arterial thrombosis (stoke, MI, renal thrombosis)
• Pregnancy complications (miscarriage, stillbirth, pre-eclampsia)
• Livedo reticularis (purple lace like rash giving mottled appearance to skin)
• Libmann-Sacks endocarditis (non-bacterial endocarditis)
• Thrombocytopenia

Question 3

Diagnosis and management of antiphospholipid syndrome

Answer 3

• Hx of thrombosis or pregnancy complication plus antibodies
  
  • Lupus antigcoagulant
  • Anticardiolipin antibodies
  • Anti-beta-2 glycoprotein I antibodies
• Management
  
  • Long term warfarin with INR in range of 2-3
  • LMWH in pregnant women plus aspirin to reduce risk of complications