Antiphospholipid Syndrome

1 What is Antiphospholipid Syndrome?

Antiphospholipid syndrome (APS) is an autoimmune disease characterized by frequent clotting in arteries and veins. Clotting is caused by anti-phospholipid autoantibodies which attack normal proteins in the blood. Clotting may lead to pregnancy complications and heart attacks. 

These antibodies may also cause clotting in leg veins called deep vein thrombosis (DVT). Damage caused by clot depends on the size and location of the clot. Repeated formation of clots may lead to organ damage. 

APS can be fatal when clots are formed in organs like heart, lungs, or brain. There is no cure for APS, but medications reduce the risk of blood clots and prevent organ damage.

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2 Symptoms

Common symptoms of Antiphospholipid syndrome include: 

  • Blood clots in the deep veins of legs, called DVT
  • Clots that move to lungs, called pulmonary embolism
  • Miscarriages during pregnancy, mostly during later parts of first trimester or early parts of second trimester
  • Complications of pregnancy like premature delivery or high blood pressure
  • Stroke
  • Blood clots in arteries of hands and legs called peripheral arterial thrombosis

Less common symptoms of the condition include: 

  • Neurological problems like headaches, dementia, and seizures
  • Lacy bluish rashes called livedo reticularis
  • Skin ulcers, particularly on legs or feet
  • Damage to heart valves
  • Thromobocytopenia, or reduction in the number of platelets, causing bleeding from nose and gums. 
  • Cognitive issues like poor memory or concentration
  • Sudden loss of hearing

3 Causes

The main causes of Antiphospholipid syndrome are abnormal antibodies called autoantibodies.

In this autoimmune disease, the body produces antibodies against normal organs and tissues of the body. These abnormal antibodies are called autoantibodies. Autoantibodies produced in APS recognizes proteins that bind to phospholipids. Autoantibodies increase the risk of blood clots. APS is categorized into two main types:

  • Primary APS – in this type of APS, there is no underlying conditions like autoimmune disorders that result in APS. 
  • Secondary APS – APS associated with an underlying condition like autoimmune disorders, infections, or certain medications, is called secondary APS. Secondary APS is caused by the underlying condition. 

Some of the possible causes for the formation of autoantibodies are: 

  • Infections – certain infections like syphilis, HIV infection, hepatitis C and Lyme disease have an increased risk of developing APS. 
  • Medications – certain medications like hydralazine, quinidine, phenytoin, and amoxicillin are also risk factors for APS. 
  • Genetic factors – People with a family history of APS is found to have increased chance of developing APS, indicating a genetic predisposition for APS

Major risk factors for this condition are: 

  • Certain infections and medications
  • Autoimmune disorders
  • Family history

4 Making a Diagnosis

Clinical symptoms and blood tests are the basis for the diagnosis of Antiphospholipid syndrome. Blood test are used to check for the presence of autoantibodies. 

Anticardiolipin antibodies, Lupus anticoagulant, and antibodies to β2-glycoprotein are the antibodies checked in blood tests. Presence of these antibodies at least twice in blood tests conducted once in 12 weeks confirms APS.

5 Treatment

Medications that reduce clot formation are used to treat Antiphospholipid syndrome. Anticoagulant medications given to control the symptoms are heparin, warfarin, and aspirin. Combination of these drugs is the first step in the treatment of APS. 

During pregnancy, heparin and aspirin are given as a part of anticoagulation therapy to prevent miscarriage. Adding aspirin to heparin during pregnancy increases the chance of successful pregnancy. Dosage of the medication is based on blood tests so that body still retain the clotting ability when bleeding starts.

6 Prevention

There is no standard way of preventing Antiphospholipid syndrome. Complications of APS can be prevented by using anticoagulant medications.

7 Alternative and Homeopathic Remedies

To ease your Antiphospholipid syndrome symptoms, you can try some alternative and homeopathic remedies such as integrative therapy.

Integrative therapy including policosanol, aortic acid, garlic, ginger, rutin, seaweed, kelp, and bladderwrack is used to reduce blood clots.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with Antiphospholipid syndrome.

Those who are on anticoagulants should avoid risky and high contact sports to avoid bruising and bleeding. Gum bleeding can be prevented by using soft brushes and waxed flosses. Shaving with electric razor reduces risk of bleeding. 

Certain foods are known to influence the effect of anticoagulants. Foods with vitamin K reduces the effect, while cranberry and alcohol increase the blood-thinning effect of the medication. Medications, herbal supplements, and vitamins should be had only after discussion with the doctor to avoid interactions.

9 Risks and Complications

Complications of Antiphospholipid syndrome depend on the size and location of blood clots. APS may lead to kidney damage, stroke, heart diseases, lung problems, and complications in pregnancy.