Antiphospholipid Syndrome

Antiphospholipid syndrome (APS) is characterized by the following:

• venous or arterial thrombosis--a condition where clots, called thrombi, form in the blood vessels;

• recurrent miscarriages--the repeated loss of the fetus in pregnancies; and

• thrombocytopenia--a low number of blood platelets that can lead to bleeding, seen as bruising and tiny red dots on the skin.

Patients with APS also may experience symptoms of stroke such as transient ischemic attacks (TIAs).

APS is diagnosed based on the above clinical manifestations and on laboratory test results. A blood sample is analyzed for the presence of antibodies that react with naturally occurring proteins complexed (bound together) with phospholipids. These are called antiphospholipid antibodies or anticardiolipin antibodies (cardiolipin is one type of phospholipid used in lab tests). Sometimes these antibodies are called lupus anticoagulants when clotting assays (a testing method) are used for their detection.

The way in which these antibodies cause clinical problems is not well understood. Patients with APS may develop systemic lupus erythematosus, an autoimmune disorder (where antibodies fight against the body's own tissue); these patients should be followed periodically by a doctor who specializes in rheumatology. However, not all APS patients develop lupus. The tendency to have autoimmune disorders is inherited, but APS is not necessarily inherited. It is anticipated that continuing research will reveal more about the disease and lead to a greater understanding of all aspects of APS.

Treatment of APS is directed at the clinical manifestations of the disease. Warfarin and aspirin are anticoagulants used to treat thrombosis. Prompt treatment is necessary because thrombi can break away from the emboli (blood vessel walls) and travel to the lungs and lodge there. Frequent followup visits are needed to evaluate the effectiveness of these anticoagulants.

For pregnant patients, heparin and aspirin are usually used to prevent thrombosis and miscarriage. Corticosteroid therapy using prednisone, along with aspirin, is sometimes used instead of heparin. Heparin and aspirin also are recommended to treat patients undergoing surgery.

Information provided by the
National Heart, Lung, and Blood Institute,
National Institutes of Health.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.