Antiphospholipid Syndrome Flashcards
Define Anti-Phospholipid Syndrome?
Characterised by the presence of antiphospholipid antibodies (APL) in the plasma, venous and arterial thrombosis, recurrent foetal loss and thrombocytopaenia
What is the aetiology of Anti-Phospholipid Syndrome?
Antiphospholipid antibodies (APL) are directed against plasma proteins bound to phospholipids
APL may develop in susceptible individuals following exposure to infectious agents
Once APL are present, a second event is needed for the syndrome to develop
APL has effects on a number of coagulation factors (e.g. protein C, annexin V, platelets, fibrinolysis)
Complement activation by APL is critical for the complications
What is the epidemiology of Anti-Phospholipid Syndrome?
More common in YOUNG WOMEN
Accounts for 20% of strokes in < 45 yrs
Accounts for 27% of women with > 2 miscarriages
What are the presenting symptoms of Anti-Phospholipid Syndrome?
Headaches (migraine)
Chorea
Epilepsy
What do you normally see on a histroy of Anti-Phospholipid Syndrome?
Arterial thromboses (stroke) Venous thromboses (DVT, PE) Recurrent Miscarriages
What are the signs of Anti-Phospholipid Syndrome?
Liverdo reticularis
Signs of SLE (e.g. malar rash, discoid lesions)
Signs of valvular heart disease
What is Livedo Reticularis?
A skin finding consisting of a mottled reticulated vascular pattern that appears as a lace-like purplish discolouration of the skin
What investigations do we do for Anti-Phospholipid Syndrome?
FBC
ESR
U&Es
Clotting Screen
What do we see on FBC for Anti-Phospholipid Syndrome?
Low platelets
What do we see on an ESR for Anti-Phospholipid Syndrome?
Usually normal
Why do we do U&Es for Anti-Phospholipid Syndrome?
Can get APL nephropathy
What do we see on a clotting screen for Anti-Phospholipid Syndrome?
High APTT
How can the presence of antiphospholipid antibodies be demonstrated?
ELISA testing for anticardiolipin antibodies
Lupus anticoagulant assays
