What Is It?
Antiphospholipid Antibody Syndrome (APS) is an autoimmune condition in which the body produces antibodies that increase the tendency of blood to clot. These clots can occur in veins, arteries, or the placenta during pregnancy.
APS may occur:
- On its own isolated condition (Primary APS)
- Along with other autoimmune diseases, especially Systemic Lupus Erythematosus (SLE) (secondary APS)
Why does APS occur?
The immune system produces abnormal antibodies. These antibodies interfere with normal blood clotting and leads to an increased risk of thrombosis and pregnancy complications.
Common Problems Caused by APS
Blood Clots:
- Blood clot in the veins usually leg veins are affected commonly but any vein or artery can be affected (leg or arm swelling, pain)
- Blood clotting in the blood vessels of brain causes stroke or transient ischemic attack (TIA)
- Heart attack (rare)
- Pulmonary embolism- blood clotting in the blood vessels of lungs (sudden breathlessness, chest pain)
- Digital gangrene
Pregnancy-Related Problems:
During pregnancy antiphospholipid antibodies leads to blood clotting in the vessels of the placenta leading to
- Recurrent miscarriages
- Stillbirth
- Pre-eclampsia
- Growth restriction of the baby
Other Symptoms:
- Headaches or migraines
- Low platelet count
- Skin rashes (livedo reticularis – net-like skin pattern)
- Seizures or memory problems (rare)
How Is APS Diagnosed?
Diagnosis requires both clinical events and blood tests.
1. Blood Tests (done twice, at least 12 weeks apart)
- Lupus anticoagulant
- Anticardiolipin antibodies
- Anti-β2 glycoprotein I antibodies
2. Clinical History
- Previous blood clots
- Pregnancy losses or complications
Treatment Options
Management of thrombosis involves treatment with the blood thinners initially injectable and then oral tablets. Low platelet counts sometimes requires additional treatment in the form of steroids and immunosuppressants.
During Pregnancy
- Heparin injections throughout the pregnancy
- Close monitoring by rheumatologist and obstetrician
