Antiphospholipid Syndrome (APS)

Table of Contents

Antiphospholipid antibodies are antibodies (proteins that kills foreign substances) that interfere with the way blood vessels function.  These antibodies react with proteins in the blood that are bound to phospholipids (a type of fat molecule that is part of the normal cell membrane). 

Antiphospholipid syndrome, also known as Hughes syndrome is an autoimmune disorder common in Lupus, characterized by recurrent arterial or venous thrombosis and/or fetal losses coupled with persistently elevated levels of antiphospholipid antibodies.

The two most commonly measured antibodies associated with the antiphospholipid syndrome are the Lupus Anticoagulant and Anticardiolipin Antibodies.  There is a third class of antibodies associated with the antiphospholipid syndrome.  The Anti-Beta 2 Glycoprotein 1 is included in this class. 

These antibodies were first discovered in Lupus patients but as many as 50% of people with them do not have Lupus. 

As with all antibodies the levels fluctuate over time.

The Lupus Anticoagulant Tests

Coagulation tests that measure clotting time are used to find the Lupus Anticoagulant.  If the number of seconds it takes for the blood to clot is longer than normal, the Lupus Anticoagulant is suspected and further testing is undertaken.

Anticardiolipin Antibodies

There are 3 kinds of anticardiolipin antibodies.  Immunoglobulin A (IgA), Immunoglobulin G (IgG), and Immunoglobulin M (IgM).  IgG is the type most often associated with complications.

Possible risks for people with these antibodies:

• Deep Vein Thrombosis

• Gangrene

• Purpura

• Avascular Necrosis

• Pulmonary Embolism

• Heart Attack

• Stroke

• Miscarriage

• Preterm Labor

• Preeclampsia

Treatment usually includes low dose aspirin or other blood thinners such as wafarin (Coumadin).  Heparin is used for thrombosis. 

Patients with APS should eliminate other risk factors such as oral contraceptives, obesity, smoking, hypertension, and hyperlipidemia.

Pregnancies in APS patients are considered "high risk" and should be closely monitored.