[Antiphospholipid syndrome: a new clinical entity? Part 2: pathophysiological aspects and treatment possibilities]

Antiphospholipid antibodies are immunoglobulins of the IgG, IgM or rarely IgA class directed against phospholipids or phospholipid-protein complexes of the coagulation cascade. They were first described in patients with systemic lupus erythematosus, but are also frequent in other autoimmune diseases, lymphoproliferative and malignant disorders, some bacterial and viral infections, and after drug exposure. Their mechanism of action is considered multiple, disturbing various natural inhibitory pathways of coagulation. Clinically they have been associated with a thrombotic tendency without a proven direct causal role. Both arterial and venous thromboses, as well as habitual abortion in pregnant women, are reported. A variety of treatment measures have been tried against these associated clinical manifestations.