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Antiphospholipid syndrome – Causes, symptoms, diagnosis, and management

Antiphospholipid syndrome – Causes, symptoms, diagnosis, and management

Antiphospholipid syndrome (APS) affects the blood’s clotting process. It causes abnormal blood clots to form in the blood vessels, resulting in thrombophilia. Unfortunately, the condition is often underdiagnosed despite its life-threatening consequences. It may be because it is the primary effect of various ailments, and its symptoms overlap with other diseases. Nonetheless, early and accurate diagnosis is the key to preventing severe complications. Learn about antiphospholipid syndrome’s signs, causes, and treatment options in this post.

Causes
Antiphospholipid syndrome, also known as Hughes syndrome and sticky blood, is an autoimmune disorder. It occurs when the immune system secretes abnormal proteins known as antiphospholipid antibodies. These antibodies attack the phospholipids, a particular kind of fat found in the body’s cells. This, in turn, leads to the formation of blood clots in the arteries, veins, or other blood vessels, increasing the risk of complications.

If the condition affects pregnant women, it can cause tiny blood clots to get stuck in the placenta. The clots can stop the flow of healthy nutrients to the infant, resulting in miscarriage.

Antiphospholipid syndrome can be classified into two types, primary and secondary, depending on the cause. The former occurs on its own, without an underlying health condition, while the latter is triggered by the progression of another autoimmune disease, such as systemic lupus erythematosus (SLE).

Symptoms
The symptoms of antiphospholipid syndrome differ based on where the blood clots are formed and how they travel through the veins. The formation of blood clots can lead to the following symptoms:

Deep vein thrombosis (DVT), characterized by pain or swelling in the thigh or calf
Pulmonary embolism (PE), or blood clots in the artery that induce lung-related signs like breathing difficulty and chest pain
Miscarriages, preeclampsia, and preterm delivery
A stroke resulting from interrupted blood supply to the brain
An abnormal heart valve
Decreased count of platelets in the blood, resulting in bleeding
Headaches
Seizures
A red rash on the knees and wrists referred to as livedo reticularis

Although the above signs might overlap with other conditions, they indicate a serious problem. Hence, one should visit a healthcare expert to determine the cause.

Diagnostic tests
Three major antiphospholipid syndrome tests used to diagnose the condition are:

Anticardiolipin antibody test
It helps detect two types of antibodies, IgG and IgM, that can bind with cardiolipin, a type of phospholipid. The test results are provided in the numerical value of MPL or GPL units. Higher than 40 MPL or GPL units are considered severe or positive.

Anti-beta-2-glycoprotein I
This test assesses the ability of IgG and IgM to attach to beta-2-glycoprotein I, a type of protein connected to the phospholipids in the body. The results are given in numerical values. Higher values indicate an increased risk of blood clotting.

Lupus anticoagulant test
Unlike what the name suggests, the test is not meant to diagnose lupus but evaluate the presence of antiphospholipid antibodies, which affect the normal clotting process of the blood. The result can be either positive or negative. A positive result indicates a higher risk of clotting and miscarriages.

A healthcare professional may suggest the above diagnostic tests for individuals with:

Recurrent thrombosis
Unprovoked thrombosis with no risk factors
Thrombotic stroke under the age of 50 years
Miscarriage in the second trimester
Repeated miscarriage in the first trimester
Repetitive complications in delayed pregnancy
SLE patients who suffer from clots and miscarriage

Treatment and management
There is no cure or definitive treatment for antiphospholipid syndrome. Doctors aim to prevent future episodes of the condition, be it clotting or miscarriages. When a patient with a confirmed diagnosis visits a healthcare expert, they may recommend treatments to thin the blood and prevent blood clots. This is especially true for people with an acute blood clot or blood clot in the artery. If the clots result from an underlying health condition, doctors may suggest remedies to treat that condition.

Women who have been suffering from recurrent miscarriages and have antiphospholipid syndrome may be prescribed combination therapy to prevent miscarriages and deliver a healthy baby. The treatment is usually started in the early stage of pregnancy and continues after the delivery.

The symptoms and severity of antiphospholipid syndrome vary from person to person, which impacts treatment and prognosis. Nonetheless, early diagnosis and timely remedies reduce the chances of severe complications, such as miscarriage or stroke. Women diagnosed with the condition should plan their pregnancy with a gynecologist’s guidance. Most patients can lead a normal and active life with proper treatment and a healthy lifestyle.