Ch 54 Antiohospholipid Antibidy Syndrome

Question 1

Antiphospholipid antibodies are antibodies that are directed against negatively charged phospholipids and include lupus anticoagulant and anticardiolipin antibodies.

Answer 1

T

Question 2

Antiphospholipid antibody syndrome is an autoimmune condition characterized by recurrent arterial or venous thrombosis (or both), thrombocytopenia, and fetal losses, especially still births during second half of pregnancy

Answer 2

T

Question 3

There is strong associati b between presence of lupus anticoagulant and anticardiolipin antibodies with decidual vasculioathy, placental infarction, fetal growth restriction, early-onset preeclampsia, and recurrent fetal death

Answer 3

T

Question 4

Becuz only approximately 20% of patients with antiphospholipid antibody syndrome have a positive lupus anticoagulant reaction alone, both clotting test to identify lupus anticoagulant and anticardiolipin ELISA test must be performed.

Answer 4

T

Question 5

Clinical and lab criteria for diagnosis of antiphospholipid syndrome

Answer 5

1. 3 or
   More spontaneous abortions before 10 wks.
   One or more u explained deaths at or beyond the 10th Si of gestation.
   Severe preeclampsia or placental insufficiency necessitating birth before 34 wks

Unexplained venous thrombosis
Unexplained arterial thrombosis
Small vessel thrombosis in any tissue or organ

Laboratory:
Anticardiolipin antibody of off or ohm isotope in medium to high timers, on two or more occasions 6 weeks apart measured by standardized enzyme linked immunoabsorbent assay

Lupus anticoagulant present in plasma , 2 or more occasions, 6 wks apart

Question 6

Indications for testing for antiphospholipid antibodies

Answer 6

One or more unexplained deaths of morphologicallynnormal fetus at or beyond 10wk

One or more preterm birth of morphologically normal neonate at or before 34 wk from preeclampsia, eclampsia, or placental insufficiency

3 or more unexplained consecutive spontaneous abortions before 10wks
Venous / arterial thrombosis

Question 7

Management for women with aps without prior pregnancy loss or thrombosis

Answer 7

No treatment, daily treatment with low dose aspirin,

Low dose heparin + aspirin

Question 8

Aps with prior fetal death or recurrent pregnancy loss

Answer 8

Heparin in prophylactic doses (15,000-20,000) subcutaneously in divided doses and low dose aspirin daily