Antiphospholipid Syndrome Flashcards

1
Q

Define Anti-Phospholipid Syndrome?

A

Characterised by the presence of antiphospholipid antibodies (APL) in the plasma, venous and arterial thrombosis, recurrent foetal loss and thrombocytopaenia

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2
Q

What is the aetiology of Anti-Phospholipid Syndrome?

A

Antiphospholipid antibodies (APL) are directed against plasma proteins bound to phospholipids
APL may develop in susceptible individuals following exposure to infectious agents
Once APL are present, a second event is needed for the syndrome to develop
APL has effects on a number of coagulation factors (e.g. protein C, annexin V, platelets, fibrinolysis)
Complement activation by APL is critical for the complications

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3
Q

What is the epidemiology of Anti-Phospholipid Syndrome?

A

More common in YOUNG WOMEN
Accounts for 20% of strokes in < 45 yrs
Accounts for 27% of women with > 2 miscarriages

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4
Q

What are the presenting symptoms of Anti-Phospholipid Syndrome?

A

Headaches (migraine)
Chorea
Epilepsy

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5
Q

What do you normally see on a histroy of Anti-Phospholipid Syndrome?

A
Arterial thromboses (stroke)
Venous thromboses (DVT, PE)
Recurrent Miscarriages
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6
Q

What are the signs of Anti-Phospholipid Syndrome?

A

Liverdo reticularis
Signs of SLE (e.g. malar rash, discoid lesions)
Signs of valvular heart disease

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7
Q

What is Livedo Reticularis?

A

A skin finding consisting of a mottled reticulated vascular pattern that appears as a lace-like purplish discolouration of the skin

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8
Q

What investigations do we do for Anti-Phospholipid Syndrome?

A

FBC
ESR
U&Es
Clotting Screen

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9
Q

What do we see on FBC for Anti-Phospholipid Syndrome?

A

Low platelets

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10
Q

What do we see on an ESR for Anti-Phospholipid Syndrome?

A

Usually normal

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11
Q

Why do we do U&Es for Anti-Phospholipid Syndrome?

A

Can get APL nephropathy

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12
Q

What do we see on a clotting screen for Anti-Phospholipid Syndrome?

A

High APTT

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13
Q

How can the presence of antiphospholipid antibodies be demonstrated?

A

ELISA testing for anticardiolipin antibodies

Lupus anticoagulant assays

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