Anti-Phospholipid Syndrome

Question 1

What are two conditions you’d expect with APS?

Answer 1

thrombosis (arterial or venous)

recurrent miscarriages

Question 2

Auto Abs

Answer 2

IgA anti-B2-glycoprotien 1 (more common)

IgA anti-cardiolipin Ab

Question 3

Epidemiology?

Answer 3

prevalence increases with age

Question 4

Most common venous manifestation? Arterial?

Answer 4

DVT

Stroke

Question 5

Pregnancy losses typically occur after:

How can you prevent this?

Answer 5

10 wks genstation

low dose aspirin and heparin

Question 6

What is Catastrophic APS?

Answer 6

rare form of APS that consists of multiple thromboses of medium and small arteries occurring over days

Question 7

What lab values will be positive?

Answer 7

aPLs
Microhematuria
non-nephrotic proteinuria
Coombs test

Question 8

Clinical features?

Answer 8

o Livedo reticularis
o Thrombocytopenia
o Autoimmune hemolytic anemia
o Vegetations or thickening on cardiac valves
o Renal impairment due to ischemia in the small renal vessels
o MS like symptoms

Question 9

Pathogenesis:

Answer 9

1. apoptosis&raquo_space; inefficiently cleared cells
2. AutoAbs against B2-glycoprotein 1 develop + loss of tolerance (APC > T > B > Ab)
3. Ab bind membranes of endothelial cells, platelets, monocytes, and trophoblasts
4. complement activated&raquo_space; symptoms