Find information on thousands of medical conditions and prescription drugs.

Antiphospholipid syndrome

Antiphospholipid syndrome (or antiphospholipid antibody syndrome) is a disorder of coagulation which causes thrombosis in both arteries and veins, as well as recurrent miscarriage. It is due to the autoimmune production of antibodies against cell membrane constituents. It is occasionally referred to as Hughes' syndrome after the rheumatologist Dr Graham R.V. Hughes (St. Thomas' Hospital, London, UK). more...

Home
Diseases
A
Aagenaes syndrome
Aarskog Ose Pande syndrome
Aarskog syndrome
Aase Smith syndrome
Aase syndrome
ABCD syndrome
Abdallat Davis Farrage...
Abdominal aortic aneurysm
Abdominal cystic...
Abdominal defects
Ablutophobia
Absence of Gluteal muscle
Acalvaria
Acanthocheilonemiasis
Acanthocytosis
Acarophobia
Acatalasemia
Accessory pancreas
Achalasia
Achard syndrome
Achard-Thiers syndrome
Acheiropodia
Achondrogenesis
Achondrogenesis type 1A
Achondrogenesis type 1B
Achondroplasia
Achondroplastic dwarfism
Achromatopsia
Acid maltase deficiency
Ackerman syndrome
Acne
Acne rosacea
Acoustic neuroma
Acquired ichthyosis
Acquired syphilis
Acrofacial dysostosis,...
Acromegaly
Acrophobia
Acrospiroma
Actinomycosis
Activated protein C...
Acute febrile...
Acute intermittent porphyria
Acute lymphoblastic leukemia
Acute lymphocytic leukemia
Acute mountain sickness
Acute myelocytic leukemia
Acute myelogenous leukemia
Acute necrotizing...
Acute promyelocytic leukemia
Acute renal failure
Acute respiratory...
Acute tubular necrosis
Adams Nance syndrome
Adams-Oliver syndrome
Addison's disease
Adducted thumb syndrome...
Adenoid cystic carcinoma
Adenoma
Adenomyosis
Adenosine deaminase...
Adenosine monophosphate...
Adie syndrome
Adrenal incidentaloma
Adrenal insufficiency
Adrenocortical carcinoma
Adrenogenital syndrome
Adrenoleukodystrophy
Aerophobia
Agoraphobia
Agrizoophobia
Agyrophobia
Aicardi syndrome
Aichmophobia
AIDS
AIDS Dementia Complex
Ainhum
Albinism
Albright's hereditary...
Albuminurophobia
Alcaptonuria
Alcohol fetopathy
Alcoholic hepatitis
Alcoholic liver cirrhosis
Alektorophobia
Alexander disease
Alien hand syndrome
Alkaptonuria
Alliumphobia
Alopecia
Alopecia areata
Alopecia totalis
Alopecia universalis
Alpers disease
Alpha 1-antitrypsin...
Alpha-mannosidosis
Alport syndrome
Alternating hemiplegia
Alzheimer's disease
Amaurosis
Amblyopia
Ambras syndrome
Amelogenesis imperfecta
Amenorrhea
American trypanosomiasis
Amoebiasis
Amyloidosis
Amyotrophic lateral...
Anaphylaxis
Androgen insensitivity...
Anemia
Anemia, Diamond-Blackfan
Anemia, Pernicious
Anemia, Sideroblastic
Anemophobia
Anencephaly
Aneurysm
Aneurysm
Aneurysm of sinus of...
Angelman syndrome
Anguillulosis
Aniridia
Anisakiasis
Ankylosing spondylitis
Ankylostomiasis
Annular pancreas
Anorchidism
Anorexia nervosa
Anosmia
Anotia
Anthophobia
Anthrax disease
Antiphospholipid syndrome
Antisocial personality...
Antithrombin deficiency,...
Anton's syndrome
Aortic aneurysm
Aortic coarctation
Aortic dissection
Aortic valve stenosis
Apert syndrome
Aphthous stomatitis
Apiphobia
Aplastic anemia
Appendicitis
Apraxia
Arachnoiditis
Argininosuccinate...
Argininosuccinic aciduria
Argyria
Arnold-Chiari malformation
Arrhythmogenic right...
Arteriovenous malformation
Arteritis
Arthritis
Arthritis, Juvenile
Arthrogryposis
Arthrogryposis multiplex...
Asbestosis
Ascariasis
Aseptic meningitis
Asherman's syndrome
Aspartylglycosaminuria
Aspergillosis
Asphyxia neonatorum
Asthenia
Asthenia
Asthenophobia
Asthma
Astrocytoma
Ataxia telangiectasia
Atelectasis
Atelosteogenesis, type II
Atherosclerosis
Athetosis
Atopic Dermatitis
Atrial septal defect
Atrioventricular septal...
Atrophy
Attention Deficit...
Autoimmune hepatitis
Autoimmune...
Automysophobia
Autonomic dysfunction
Familial Alzheimer disease
Senescence
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
Medicines

A very rare form is the catastrophic antiphospholipid syndrome, in which there is rapid organ dysfunction and arterial hypertension. It carries a high mortality.

Signs and symptoms

The presence of antiphospholipid antibodies (APLAs) is suggested by thrombosis (arterial or venous) and recurrent miscarriage (especially in the second trimester, but often earlier). Other common findings, although not part of the classification, are thrombocytopenia (low platelet count) and livedo reticularis (a skin condition). Many patients report headaches.

APLAs are present in the blood in the context of a number of diseases, most notably systemic lupus erythematosus (SLE). One can only speak of antiphospolipid syndrome when there are no other symptoms of one of these diseases (e.g. arthritis suggestive of SLE). A number of patients with the syndrome (about 10%) will eventually develop SLE, but most never get signs of this disease.

Laboratory

The diagnosis is often entertained in cases of thrombophilia (recurrent thrombosis) or recurrent miscarriage. Tests that are often performed at the same time are a full blood count, liver enzyme studies and renal function studies.

Thrombophilia screening can consist of:

  • Screening coagulation studies: APTT, PT and TT.
  • Further studies for Factor V Leiden variant and the prothrombin mutation, Factor VIII levels, MTHFR mutation.
  • Levels of protein C, free and total protein S, Factor VIII, antithrombin, plasminogen, tissue plasminogen activator (TPA) and plasminogen activator inhibitor-1 (PAI-1)

Antiphospholipid syndrome is tested for in the laboratory by using a minimum of two coagulation tests that are phospholipid sensitive. The patient on initial screening will typically have been found to have a prolonged APTT that does not correct in a 80:20 mixture with normal human plasma (50:50 mixes with normal plasma are insensitive to all but the highest antibody levels). The APTT (plus 80:20 mix), dilute Russell viper venom time (DRVVT), the kaolin clotting time (KCT) or dilute thromboplastin time {TDT/DTT) are the prinicipal tests used for the detection of lupus anticoagulant. A further antibody can be detected using an enzyme-linked immunosorbant assay (ELISA) immunological test, which screens for the presence of antibodies to anticardiolipin.

Low platelet count and positivity for antibodies against β2-glycoprotein or phosphotidylserine may also be observed in a positive diagnosis.

Diagnosis

The diagnosis is made in case of a clinical event (thrombosis or recurrent miscarriage after 10 weeks gestation) and repeated positive tests of lupus anticoagulant and/or anticardiolipin antibodies performed 6-8 weeks apart. Repeat testing is necessary due to the naturally occurring presence of transient high levels of antiphospholipid antibodies following infection and inflammation. Other antibodies, although implicated, are not yet considered relevant for diagnosis.

Read more at Wikipedia.org


[List your site here Free!]


Antiphospholipid Syndrome And Pulmonary Pathologies - Abstract
From CHEST, 10/1/00 by Michele Mastroberardino

Michele Mastroberardino, MD, FCCP(*); Antonio Ciampa, MD; Paolino Papa, MD; Luigi Grosso, MD; Antonella Argenziano, MD; Antonio Iannaccone, MD; Fiorenza Prizio, MD and Domenico Bizzarro, MD. Pulmonary Medicine, Azienda Ospedaliera San Giuseppe Moscati, Avellino, Italy; Haemathology, Azienda Ospedaliera San Giuseppe Moscati, Avellino, Italy and Pulmonary Rehabilitation, Casa di Cura Villa Margherita, Benevento, Italy.

PURPOSE: A mutual relation, which is likely to be very close, between the naturally occurring prevalence of Lupus Anticoagulant (LA) and Anticardiolipin Antibodies (ACA), and the outset of pulmonay micro-macroangiopathic disordes, has not been clearly demostrated yet. Several researches have been carried out in order to explain and ascertain the incidence and the exact recurrence of such a relation.

METHODS: 28 patients (14 males aged 39 to 75, 14 females aged 41 to 80) were investigated. The patients showed the following clinical features: 20 had pulmonary embolism (PE) and 8 patients had pulmonary hypertention (PH). The diagnostic investigation based on medical reports (anamnesis and physical examination); pulmonary scintigraphy and echography were also carried out. The reference values for all the tests were obtained by a group consisting of 50 healthy volunteers (25 males and 25 females, aged 18 to 60). Several essay systems were used in order to detect the presence of LA (screening tests)and to confirm the antiphospholipid nature of the inhibitor (confirmatory test). The following screening tests were carried out: Prothrombine Time (PT), Partial Thromboplastin Time (PTT), Kaolin Clotting Time (KCT), Tissue Thromboplastin Inhibition Test (TTIT) and the Diluite Russels Viper Venom (DRVVT), while the Platelet Neutralization Procedure (PNP) was carried out as a confirmation test. ACA levels (IgG and IgM isotypes) were determined by a standardized MELISA.

RESULTS: The results are shown in the following chart:

CONCLUSION: An evidence of statistical incidence of Antiphospholipid Antibodies in the patients affected by pulmonary pathologies is proved by our researches.

CLINICAL IMPLICATIONS: LA and ACA are closely related to phospholipid binding antibodies which interfere, in a number of laboratory tests. Their presence has been detected for a long time in the plasma and serum of patients suffering from different pathologies, and we think that it could interfere in pathophysiology of PE.

GRANT SUPPORT: Azienda Ospedaliera San Giuseppe Moscati, Avellino.

COPYRIGHT 2000 American College of Chest Physicians
COPYRIGHT 2001 Gale Group

Return to Antiphospholipid syndrome
Home Contact Resources Exchange Links ebay