Antiphospholipid Syndrome

Question 1

What is it?

Predisposition

Answer 1

Antiphospholipid syndrome is an acquired disorder characterised by a predisposition:
- to both venous and arterial thromboses

• recurrent fetal loss
• thrombocytopenia

Question 2

Clinical features

Answer 2

Venous thromboembolism

• Deep vein thrombosis
• Pulmonary embolism

Arterial thrombosis

• Stroke
• Myocardial infarction
• Renal thrombosis

Pregnancy complications

• Recurrent miscarriage
• Stillbirth
• Livedo reticularis: is a purple lace like rash that gives a mottled appearance to the skin.
• Libmann-Sacks endocarditis is a type of non-bacterial endocarditis where there are growths (vegetations) on the valves of the heart. The mitral valve is most commonly affected. It is associated with SLE and antiphospholipid syndrome.
• Thrombocytopenia (low platelets) is common in antiphospholipid syndrome.

Question 3

Diagnosis

Answer 3

History of thrombosis / recurrent miscarriage AND blood tests showing:

• Lupus anticoagulant
• Anticardiolipin antibodies

Extra: paradoxical rise in the APTT

Question 4

Management

Answer 4

Warfarin:

• aim for 2-3
• if recurrent thrombosis aim for 3-4

Question 5

What condition is associated with this syndrome?

Answer 5

SLE