Antiphospholipid Syndrome (APS)

Antiphospholipid Syndrome (APS)

Articleantiphospholipidsyndrome
Women's Health
Diseases & Conditions
+4
Contributed byMaulik P. Purohit MD MPHJan 12, 2019

What are the other Names for this Condition? (Also known as/Synonyms)

  • Hughes Syndrome
  • Lupus Anticoagulant Syndrome
  • Sticky Blood Syndrome due to Antiphospholipid Syndrome

What is Antiphospholipid Syndrome? (Definition/Background Information)

  • Antiphospholipid Syndrome (APS) is a condition in which the body produces antibodies against its own tissues. As a result of this, excessive blood clots are formed in both arteries and veins, as well as in the placenta (tissue that provides nutrients to the baby) in pregnant women
  • The clots in arteries may block blood traveling from the heart to the rest of the body and vice versa, in case of clots in veins. Clots in the placenta may hinder nutrition and oxygen supply to the baby
  • The signs and symptoms of APS autoimmune disorder often manifest based on the site of the blood clots and the organs that are affected, such as the brain, heart, legs, or kidneys
  • Antiphospholipid Syndrome (also known as Hughes Syndrome) is treated using anticoagulant medications and bringing about certain lifestyle changes, which can help reduce the incidence of blood clots. The prognosis of APS is generally guarded

Who gets Antiphospholipid Syndrome? (Age and Sex Distribution)

  • Antiphospholipid Syndrome typically affects younger or middle-aged women, though it can occur at any age
  • The disorder may also affect men
  • Individuals of all racial and ethnic background are prone to APS

What are the Risk Factors for Antiphospholipid Syndrome? (Predisposing Factors)

Following are the risk factors of Antiphospholipid Syndrome:

  • The presence of any family member with the disorder
  • Presence of any other autoimmune diseases, like systemic lupus erythematosus (SLE), multiple sclerosis, diabetes, etc.
  • Infections, like hepatitis C, malaria, syphilis, etc.
  • Presence of any cancer
  • Use of medications, like birth control pills and hydralazine for control of blood pressure

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Antiphospholipid Syndrome? (Etiology)

  • Phospholipids are phosphorus-containing fats in our body and they play an important role in the clotting of blood
  • The body produces substances called antibodies, to defend it from foreign invaders, like bacteria, viruses, and many other pathogens
  • In Antiphospholipid Syndrome, antibodies are produced against these phospholipids, which (i.e. these antibodies) contribute to excessive clotting of blood in various organs of the body

What are the Signs and Symptoms of Antiphospholipid Syndrome?

The signs and symptoms of Antiphospholipid Syndrome may include:

  • Heart attacks and strokes at a younger age
  • Clot in leg veins, leading to pain and swelling of the legs (deep vein thrombosis)
  • Repeated miscarriage and stillbirth
  • Mental retardation in newborn
  • Frequent blood clots that may appear anywhere in the body
  • Dizziness
  • Seizures
  • Vision problems
  • Headache, migraine

How is Antiphospholipid Syndrome Diagnosed?

Antiphospholipid Syndrome may be diagnosed using the following tools:

  • Physical exam and comprehensive evaluation of medical history
  • By performing laboratory blood clotting tests for the presence of lupus anticoagulant, or by specific antibody tests for anticardiolipin antibodies
  • Blood tests to rule out other inherited conditions of blood clotting, like factor V Leiden, protein C deficiency or protein S deficiency

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Antiphospholipid Syndrome?

The complications of Antiphospholipid Syndrome may include:

  • Miscarriage, stillbirth, and premature deliveries
  • High blood pressure can occur in pregnant women (preeclampsia and eclampsia of pregnancy)
  • Blood clot in lungs can lead to increased blood pressure in the lung blood vessels, causing respiratory and heart failure
  • Blood clots in the brain can lead to a stroke
  • Blood clots in kidney can decrease blood flow to it, causing kidney failure

How is Antiphospholipid Syndrome Treated?

The following treatment methods are available for individuals with Antiphospholipid Syndrome:

  • Anticoagulants (blood thinners): These medications, like heparin, warfarin, etc. prevent the blood from clotting and can avoid any damage caused by such clots. However, during pregnancy only heparin is used, as warfarin is harmful for the baby
  • Antiplatelet drugs: Platelets are blood cells that plug the blood vessels during any injuries. There are various other substances that act on this plug, to form a clot. These antiplatelet drugs, like aspirin, prevent the formation of blood clots
  • Plasmapheresis: Special filters may be used to remove the antibodies from blood, by a process called plasmapheresis

How can Antiphospholipid Syndrome be Prevented?

Currently, there are no known ways to prevent Antiphospholipid Syndrome. But, the following lifestyle changes can reduce the occurrence of blood clots:

  • Smoking avoidance
  • Avoiding medications that  increase the risk of blood clots
  • Regular physical activity
  • Individuals with APS are advised to generally be aware of the sign and symptoms of blood clots, which may affect any body part

What is the Prognosis of Antiphospholipid Syndrome? (Outcomes/Resolutions)

  • The prognosis for Antiphospholipid Syndrome is generally excellent
  • Individuals with APS can generally lead normal healthy lives, with the help of medication and lifestyle changes

Additional and Relevant Useful Information for Antiphospholipid Syndrome:

There are various types of antiphospholipid antibodies, but the 3 most widely measured ones, are lupus anticoagulant, anticardiolipin antibody, and anti-β2 (beta-2) glycoprotein I.

The following article link will help you understand antiphospholipid antibodies (APLA) test procedure:

http://www.dovemed.com/common-procedures/procedures-laboratory/antiphospholipid-antibodies-apla-test/

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Maulik P. Purohit MD MPH picture
Approved by

Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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