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Related Experiment Videos

Antiphospholipid-thrombosis syndromes.

R L Bick1, B Arun, E P Frenkel

  • 1Division of Hematology Oncology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Haemostasis
|January 12, 2000
PubMed
Summary

Antiphospholipid antibodies are a common cause of thrombosis, affecting various conditions from venous thrombosis to recurrent miscarriage. Early diagnosis and appropriate antithrombotic therapy are crucial, as many patients do not respond well to warfarin.

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Area of Science:

  • Hematology
  • Immunology
  • Vascular Medicine

Background:

  • Antiphospholipid antibodies (aPL) are linked to thrombosis, representing a frequent acquired blood protein defect.
  • aPL are implicated in diverse thrombotic conditions, including venous thrombosis, cerebrovascular events, and recurrent fetal loss.

Purpose of the Study:

  • To highlight the association between antiphospholipid antibodies and various thrombotic events.
  • To discuss diagnostic challenges and appropriate testing strategies for antiphospholipid syndrome.
  • To emphasize the importance of identifying aPL for effective antithrombotic therapy.

Main Methods:

  • Review of clinical experience and existing literature on antiphospholipid antibodies and thrombosis.
  • Discussion of diagnostic assays including ELISA for anticardiolipin antibodies and dilute Russell's viper venom time for lupus anticoagulant.

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  • Consideration of specific phospholipid assays for complex diagnostic cases.

    • Main Results:

    • aPL are present in a significant percentage of patients with unexplained venous thrombosis (25%), cerebrovascular thrombosis (60%), transient ischemic attacks (37%), premature coronary artery thrombosis (18%), and recurrent fetal loss (60%).
    • Standard coagulation tests like aPTT can be unreliable for diagnosing antiphospholipid syndrome.
    • Approximately 65% of patients with aPL may not respond effectively to warfarin therapy.

    Conclusions:

    • Antiphospholipid antibodies are a significant risk factor for various thrombotic and thromboembolic events.
    • Accurate diagnostic testing, including specific assays, is essential for identifying antiphospholipid syndrome.
    • Tailored antithrombotic therapy is critical for patients with antiphospholipid antibodies due to potential warfarin resistance.