Antiphospholipid syndrome

What is antiphospholipid syndrome?

Antiphospholipid syndrome, also known as Hughes syndrome, is an autoimmune disorder that can cause blood clots anywhere in the body. It involves the production of antibodies called antiphospholipids, which attack proteins on the outside of blood cells.

In addition to causing blood clots, antiphospholipid syndrome can cause complications during pregnancy.

Prognosis of the condition

The symptoms of antiphospholipid syndrome vary greatly from person to person. For some people, blood clots will be minor and limited to the peripheral arteries, while they may cause a heart attack or stroke in others. Virtually any part of the body can be affected, so the condition can be extremely unpredictable.

Catastrophic antiphospholipid syndrome (CAFS) involves blood clots in multiple organs that occur over a period of a few days to a few weeks. This can often be fatal, but CABS affects less than 1% of people with antiphospholipid syndrome.

Antiphospholipid syndrome is an autoimmune disorder.

What are the symptoms?

In addition to blood clots, antiphospholipid syndrome can cause the following symptoms:

  • Liverdo reticularis, a red or blue blotchy rash.
  • Extreme fatigue
  • Pins and needles sensation in the arms or legs
  • Swelling and redness in the veins of the legs
  • Problems during pregnancy, such as frequent miscarriages or premature births because of high blood pressure

How is it diagnosed?

Initially, the physician will perform a medical evaluation, asking about symptoms, any past blood clots, and any unexplained miscarriage or premature birth.

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In most cases, the diagnosis involves blood tests for antiphospholipids. You will need two blood tests, spaced at least 12 weeks apart to rule out the possibility of short-term development of antiphospholipids due to medications or infection.

What causes antiphospholipid syndrome?

The cause of antiphospholipid syndrome is unknown. Some people with antiphospholipid syndrome have a family member with the condition, but most do not.

Antiphospholipid syndrome occurs in 1-5% of the healthy population, but is much more common in people with autoimmune disorders such as:

  • Systemic lupus erythematosus
  • Rheumatoid arthritis
  • Systemic sclerosis
  • Giant cell arthritis

You can also get antiphospholipid antibodies if you have had an infection, sickle cell disease or malignant lymphoma.

The most common group of people affected are women of childbearing age.

How is it treated?

Antiphospholipid syndrome is usually treated with medications to thin the blood and reduce the chances of blood clots. In the past, warfarin was the only anticoagulant medication available, but a new class of medications known as DOACs have become available in recent years, so your doctor will discuss the benefits and drawbacks of each option. You may also be prescribed an antiplatelet medication such as aspirin.

These medications will usually need to be taken daily for the rest of your life. During pregnancy you may additionally need to take heparin.

Finally, there are some things you can do to lower your blood pressure and, therefore, your chances of blood clots, such as:

  • Exercising regularly
  • Maintaining a healthy weight
  • Eating a healthy, balanced diet
  • Quitting smoking