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[Antiphospholipid syndrome : Update on diagnostics and management].
Christof Specker1, Rebecca Fischer-Betz2, Thomas Dörner3
1Klinik für Rheumatologie & Klinische Immunologie, Kliniken Essen-Mitte, Pattbergstr. 1-3, 45239, Essen, Deutschland. specker@uni-duesseldorf.de.
Zeitschrift Fur Rheumatologie
|March 19, 2020
Summary
Antiphospholipid syndrome (APS) involves blood clots and pregnancy complications, identified by specific antibodies. Triple positivity for these antibodies indicates a high risk, necessitating careful treatment strategies.
Area of Science:
- Rheumatology
- Immunology
- Hematology
Background:
- Antiphospholipid syndrome (APS) initially identified in systemic lupus erythematosus (SLE) patients.
- Characterized by thromboembolic events and pregnancy complications.
- Serological markers include anticardiolipin antibodies (aCL), lupus anticoagulant (LA), and antibodies against beta-2 glycoprotein I (aB2GPI).
Purpose of the Study:
- Distinguish primary APS from secondary APS associated with SLE.
- Highlight the significance of specific antibody profiles in risk stratification.
- Evaluate current prophylactic treatments for APS.
Main Methods:
- Review of serological criteria for APS diagnosis.
- Analysis of clinical outcomes based on antibody positivity.
- Assessment of treatment efficacy for thromboembolic and obstetric complications.
Main Results:
- Triple positivity (aCL, aB2GPI, LA) signifies a high-risk profile for APS.
- Immunosuppression is ineffective for preventing further thromboembolic events in APS.
- Low-dose aspirin, heparin, and vitamin K antagonists are standard prophylactic treatments.
Conclusions:
- High-risk APS patients require tailored management strategies.
- Direct oral anticoagulants are associated with increased complications in high-risk APS.
- Current prophylactic treatments remain the cornerstone of APS management.
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