Antiphospholipid Syndrome (APS)
- Article
- 2021-03-02
Antiphospholipid Syndrome (APS) is an autoimmune disease caused when antibodies - cells of the immune system that fight bacteria and viruses - mistakenly attack healthy body tissues and organs. In APS, specific antibodies activate the inner wall of blood vessels, leading to the formation of blood clots in arteries or veins. APS is sometimes referred to as "sticky blood syndrome" because of its increased tendency to form blood clots in the veins and arteries. The symptoms of APS are due to the abnormal blood clotting. Clots can form in the veins of the legs and lungs, or in the placenta of pregnant women. One of the most serious complications of APS occurs when a clot forms in the brain and causes a stroke. Other neurological symptoms include chronic headaches, dementia (similar to Alzheimer's dementia), and seizures. chorea (a movement disorder in which the body and limbs twitch uncontrollably), cognitive impairment (such as poor memory), transverse myelitis, depression or psychosis, optic neuropathy or sudden hearing loss. In pregnant women, clots in the placenta can cause miscarriages. APS is diagnosed by the presence of a positive antiphospholipid antibody and a history of blood clots in an artery or vein or a history of multiple miscarriages or other pregnancy problems. Some people have a characteristic lacy, net-like red rash called livingo reticularis across their wrists and knees.
Therapy
The main goal of treatment is to thin the blood to reduce clotting. Currently, the recommended treatment is low-dose aspirin. For people who have already had a stroke or have recurring blood clots, doctors recommend treatment with the anticoagulant warfarin. Pregnant women are treated with aspirin or another anticoagulant - heparin - because warfarin can cause birth defects.
Prognosis
APS improves significantly with anticoagulant therapy, reducing the risk of further blood clots in veins and arteries. Treatment should be lifelong as there is a high risk of further blood clots in people who stop treatment with warfarin. Doctors often recommend that people quit smoking, exercise regularly, and eat a healthy diet to prevent high blood pressure and diabetes, which are diseases that increase the risk of stroke. Treating pregnant women with aspirin or heparin usually prevents miscarriages related to APS.
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