Expired CME Article
Antiphospholipid Syndrome: Review
Abstract
Antiphospholipid syndrome spans many medical disciplines. Classic criteria include the presence of anticardiolipin antibody or lupus anticoagulant with typical complications of thrombosis or pregnancy loss. Other common associated manifestations include livedo reticularis, thrombocytopenia, valvular heart disease, and nephropathy with renal insufficiency, hypertension, and proteinuria. Treatment of serious complications with anticoagulation is standard; generally warfarin for thrombosis and aspirin/heparin for pregnancy prophylaxis. Detailed recommendations regarding precise intensity and duration of anticoagulation are still a subject of debate.
Key Points
* Antiphospholipid syndrome (APS) is characterized by the presence of anticardiolipin antibody or lupus anticoagulant together with typical clinical manifestations of thrombosis or pregnancy loss and morbidity.
* The spectrum of manifestations associated with APS is broad and includes, in addition to thrombosis and pregnancy morbidity, thrombocytopenia, livedo reticularis, cardiac valvular disease, and an acute syndrome of multiorgan thrombosis termed “catastrophic antiphospholipid syndrome.”
* Treatment of APS is still evolving but generally involves anticoagulation with warfarin for thrombosis and prophylactic therapy with aspirin and heparin during pregnancy in patients with previous obstetric complications.
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