Rheumatology - Antiphospholipid Syndrome

Question 1

What happens in APLS?

Answer 1

Antiphospholipid antibodies target proteins that bind to phospholipids on the cell surface causing inflammation and increasing risk of thrombosis

Question 2

What are the specific APLS antibodies?

Answer 2

Lupus anticoagulant
Anticardiolipin antibodies
Anti-beta-2 glycoprotein I antibodies

Question 3

What are the key complications of APLS?

Answer 3

Recurrent miscarriage
Stillbirth
Pre-eclampsia
Stroke
MI
Renal thrombosis
DVT
PE

Question 4

What is catastrophic antiphospholipid syndrome?

Answer 4

Rare complication

Rapid thrombosis in multiple organs within a few days

Question 5

What are the associations of APLS?

Answer 5

SLE

Livedo reticularis
Purple lace-like (reticular) rash that gives a mottled appearance to the skin

Libmann-Sacks endocarditis
Non-bacterial endocarditis with growths on heart valves
Mainly mitral and aortic

Thrombocytopenia

Question 6

How is APLS diagnosed?

Answer 6

Clinical features and persistent antiphospholipid antibodies

Question 7

How is APLS managed?

Answer 7

Long-term warfarin- INR of 2-3 to prevent thrombosis

LMWH and aspirin in pregnancy to reduce risks
(enoxaparin)