Diagnosis of APLS<\/span><\/h2>\nBoth clinical evidence of thrombosis and the laboratory detection of antiphospholipid antibodies are needed for a diagnosis of APLS.<\/p>\n
The most common thrombotic events are DVTs, small vessel thromsosis, and ischemic strokes. Pregnancy-associated difficulties that are qualifying clinical events include the loss of a chromosomally and morphologically normal fetus after the 10th week of gestation (or 3 consecutive spontaneous abortions before 10 weeks), placental insufficiency, or eclampsia.<\/p>\n
Antiphospholipid antibodies must be detected twice separated by at least 12 weeks. The antiphospholipid antibodies that should be checked include anti-cardiolipin, anti-beta2 glycoprotein 1, and lupus anticoagulant. The abnormal antibodies could be either IgG or IgM.<\/p>\n
APLS etiology<\/h2>\n
There are three classes of APLS. In primary APLS there is no associated auto-immune disorder other than the antiphospholipid antibodies. In secondary APLS the\u00a0antiphospholipid antibodies are part of an auto-immune disease like systemic lupus erythrematosus\u00a0<\/span>(SLE).\u00a0<\/span>Catastrophic antiphospholipid syndrome describes acute multi-organ failure due to diffuse thrombosis.<\/span><\/p>\nTreatment for APLS<\/h2>\n
Treatment is directed at reducing thrombosis. Antiplatelet therapy is typically started with aspirin. Anti-coagulation is usually indicated if both antiphospholipid antibodies and thrombotic events are documented, and the type of anti-coagulation depends on the state of the patient (no coumadin in pregnant patients since it crosses the plancenta).<\/p>\n
Transesophageal echocardiography is recommended in APLS patients with strokes to evaluate for valvular abnormalities and cardiac thrombi (Panichpisal et al. 2012).\u00a0<\/span><\/p>\nPlasmapheresis is sometimes required if thrombosis continues despite anti-coagulation.<\/span><\/p>\nReferences<\/h2>\n
Panichpisal, K,\u00a0Rozner, E,\u00a0Levine, SR. The Management of Stroke in Antiphospholipid Syndrome.\u00a0Current Rheumatology Reports<\/a> February 2012 14:99-106.<\/p>\n","protected":false},"excerpt":{"rendered":"Antiphospholipid syndrome (APLS; Hughes Syndrome) produces a hypercoagulable state that can predispose to ischemic strokes as well as other thrombotic events.\u00a0<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[12],"tags":[461,459,460,182,462],"aioseo_notices":[],"yoast_head":"\n
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