Antiphospholipid Antibody Syndrome (Other manifestations (Cardiac valvular…
Antiphospholipid Antibody Syndrome
Primary or assoc w/ SLE
Ab. induced thrombosis?
Activate endothelial cells/platelets
Inhibit protein C activation
Promote tissue factor synth by leukocytes
Markers of another process?
Antiphospholipid Ab secondary to infxn or drugs usually do not experience thrombosis
Asymp aPL positivity
APS w/ vascular events
APS w/ pregnancy morbidity
1+ unexplained death of normal fetus >10 wks
1+ premature births before 34 wks gest. b/o preeclampsia, eclampsia, or placenta insufficiency
3+ unexplained consecutive SAB <10 wks gest.
3+ organs in short period
Cardiac valvular abnormalities
Positive Coomb's (10-20%)
False positive VDRL
Livedo reticularis (marbled red rash)
Renal system clots
Not great tests. Many false positives.
Repeat 12 wks apart to confirm
Lupus anticoagulant (DRVVT)
Anti-Beta 2 glycoprotein Ab
Hydroxychloroquine (for aPL pts w/ SLE)
Address other issues
Tobacco, HTN, DM, HLP
ASA (no data supporting)
ASA + Heparin
: improves fetal survival 80-90%