Chapter 11 - Antiphospholipid syndrome

Summary

Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by vascular thrombosis and/or obstetric morbidity in the presence of persistent antiphospholipid antibodies (aPL) namely, lupus anticoagulant antibodies (LAC), anti-cardiolipin antibodies (aCL) and/or anti-β2-glycoprotein I antibodies. The syndrome produces a spectrum of disease, both in terms of clinical manifestations and the presence of other autoimmune conditions. The disease is classified as primary antiphospholipid syndrome (PAPS) when it occurs in the absence of any features of other autoimmune disease, and secondary where other autoimmune disease is present secondary antiphospholipid syndrome (SAPS). Upto 30% of patients with APS have minor valvular abnormalities, which usually do not cause hemodynamic disturbance. Individual treatment strategies for the management of the APS in pregnancy in part depend on the assessment of a number of different factors. The first treatment used and studied for pregnant patients with APS, was a combination of corticosteroids and low dose aspirin.