Antiphospholipid syndrome history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The presence of antiphospholipid antibodies (aPL) in the absence of blood clots or pregnancy-related complications does not indicate APS (see below for the diagnosis of APS).

Antiphosphilipid syndrome can cause (arterial/venous) blood clots (in any organ system) or pregnancy-related complications (especially miscarriage in the second or third trimester). In APS patients, the most common venous event is deep vein thrombosis of the lower extremities (blood clot of the deep veins of the legs) and the most common arterial event is stroke.

History and Symptoms

Other common findings, although not part of the APS Classification Criteria, are thrombocytopenia (low platelet count), heart valve disease, and livedo reticularis (a skin condition). Some patients report headaches and migraines. Antiphospholipid syndrome can rarely mimic multiple sclerosis with an estimated 10% of patients misdiagnosed.

Very few patients with primary APS go on to develop SLE.

• Associated sign and symptoms may include:

  • Major Features:

    • Venous thrombosis
    • Arterial thrombosis
    • Thrombocytopenia
    • Recurrent fetal loss

  • Minor Features:

    • Migraine
    • Livedo reticularis
    • Endocardial valvular vegetations
    • Transverse myelopathy
    • Chorea
    • Leg ulcers

• Other signs and symptoms include:

  • Myocardial Infarction
  • Stroke
  • Pulmonary embolism
  • Amaurosis fugax
  • Retinal infarct
  • Other visceral infarct
  • Peripheral or deep venous occlusion
  • Raynaud’s syndrome
  • Pulmonary hypertension
  • Avascular necrosis
  • Recurrent fetal loss (especially in the 2nd or 3rd trimester)
  • Pre-eclampsia
  • Adrenal insufficiency
  • Coomb’s positive hemolysis
  • Sudden multi-systemic occlusion (the Catastropic antiphospholipid-antibody syndrome).