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Antiphospholipid thrombosis syndromes.

R L Bick1

  • 1University of Texas Southwestern Medical Center, and the Dallas Thrombosis/Hemostasis Clinical Center, USA. rbick@onramp.net

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|November 8, 2001
PubMed
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Antiphospholipid antibodies are linked to thrombosis, causing blood clotting disorders. Early diagnosis and specific treatments like LMWH or UH are crucial for preventing recurrent thrombotic events.

Area of Science:

  • Hematology
  • Immunology
  • Vascular Medicine

Background:

  • Antiphospholipid antibodies are a primary cause of acquired thrombotic disorders.
  • The exact mechanisms by which these antibodies induce a hypercoagulable state are still under investigation.
  • Antiphospholipid syndrome (APS) encompasses various thrombotic and obstetric complications.

Purpose of the Study:

  • To highlight the association between antiphospholipid antibodies and thrombosis.
  • To outline the different clinical presentations (syndromes I-VI) of APS.
  • To emphasize the importance of accurate diagnosis and appropriate management for secondary prevention.

Main Methods:

  • Review of clinical associations and diagnostic approaches for APS.
  • Assessment of different antibody types (IgG, IgA, IgM) and their clinical significance.

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  • Evaluation of diagnostic tests including ELISA, dRVVT, hexagonal phospholipid neutralization, and beta-2-GP-I assays.
  • Main Results:

    • Anticardiolipin antibodies are associated with venous (Type I) and arterial (Type II) thrombosis, while lupus anticoagulant-associated thrombosis is typically venous.
    • Specific diagnostic tests are essential due to the unreliability of aPTT in affected patients.
    • Most APS patients do not respond well to warfarin or some antiplatelet therapies.

    Conclusions:

    • Prompt diagnosis of APS is critical for effective secondary prevention.
    • Treatment strategies should be tailored based on syndrome type and antibody profile.
    • Low molecular weight heparin (LMWH) or unfractionated heparin (UH) are often the most effective anticoagulants for APS-related thrombosis.