[Antiphospholipid antibodies and antiphospholipid syndrome: diagnosis and management]

Antiphospholipid syndrome is an acquired autoimmune thrombophilia that produces significant morbidity and mortality. Its diagnosis requires the presence of antiphospholipid antibodies and clinical manifestations that include thrombotic phenomena and/or recurrent miscarriages. Antiphospholipid antibodies may be detected in many instances, including healthy subjects. Clinical manifestations are varied and may occur in episodes and also appear in other situations. Therefore, it is important to have clear guidelines in order to establish a correct diagnosis, carry out an adequate treatment, and to know which are the prophylactic measures and when they should be undertaken. In this article we explain the most recent diagnostic criteria reviewed in the 11th International Congress on Antiphospholipid Antibodies (Sydney 2004), comment on the varied clinical manifestations with special focus on cutaneous lesions, and review current guidelines for the treatment and prophylaxis of thrombotic and obstetric pathology.