Antiphospholipid Syndrome

What is Antiphospholipid Syndrome (APS)?

Antiphospholipid syndrome (APS), also called Hughes syndrome or antiphospholipid antibody syndrome, is an autoimmune disorder where your immune system produces antibodies against phospholipids, proteins that help in the formation of a blood clot. Clot formation is an important process that is required for sealing small cuts and preventing excessive bleeding. The antibodies against this protein, called antiphospholipid autoantibodies, cause increased clot formation, leading to the blockage of blood flow in the arteries and veins that supply the brain, kidneys, lungs and legs.

Risk Factors for Antiphospholipid Syndrome

There are many factors that may increase your risk of developing antiphospholipid syndrome, such as:

  • Women in their 30s are more prone to antiphospholipid syndrome than men
  • Pregnancy
  • Presence of an immune system disorder
  • Presence of infections such as HIV/AIDS, hepatitis C, syphilis or Lyme disease
  • Use of certain medications
  • Family history of antiphospholipid syndrome

Other risk factors may include:

  • Sedentary lifestyle
  • Smoking
  • Recent surgery
  • Oestrogen therapy for birth control or menopause
  • High cholesterol levels
  • High blood pressure

Signs and Symptoms of Antiphospholipid Syndrome

Antiphospholipid syndrome is characterised by the following signs and symptoms:

  • Stroke
  • Deep vein thrombosis (DVT: blood clots in the leg)
  • Pulmonary embolism (deep vein thrombosis that travels to the lungs)
  • Transient ischemic attack or TIA, similar to a stroke but lasting only a few minutes without any permanent damage
  • Rash
  • Headaches, seizures, cardiovascular disease or bleeding from gums and nose
  • Antiphospholipid syndrome during pregnancy may result in pre-eclampsia (high blood pressure), stillbirth or miscarriage

Sometimes, antiphospholipid antibodies may not show any signsor symptoms.

Complications Associated with Antiphospholipid Syndrome

The severity of the obstruction in blood flow and the organ affected determines the damage that would be caused due to antiphospholipid syndrome. If left untreated it may cause:

  • Loss of speech or partial paralysis due to permanent neurological damage
  • Cardiovascular problems
  • Kidney failure
  • Lung damage

Although rare, you may have an increased risk of multiple organ damage and even death if you suffer from repeated clotting episodes within a short duration.

When should you Consult a Doctor?

If you have trouble breathing, streaks of blood in the mucus when you cough, bright red vomit, paralysis, an abnormally heavy menstrual flow, undetermined abdominal pain or dark stools, then you must visit a specialist.

Diagnosis of Antiphospholipid Syndrome

Your doctor will diagnose antiphospholipid syndrome by ordering the following tests:

  • Immunological tests such as ELISA immunoassays, where you will be tested for the presence of antiphospholipid antibodies
  • Coagulation-based tests, where you will be tested for the presence of lupus anticoagulant, an antibody that slows down the clotting process

Treatment Options for Antiphospholipid Syndrome

There is no cure for antiphospholipid syndrome. Treatment is aimed at controlling the formation of blood clots. Your doctor may prescribe blood thinners (anticoagulants) to prevent blood clotting either as injections or oral tablets. Pregnant women may also be prescribed low doses of blood thinners until delivery to control the symptoms associated with antiphospholipid syndrome.

Adopting a healthy lifestyle, regular exercise, eating a nutritious diet and smoking cessation helps minimise symptoms of antiphospholipid syndrome. If you are a female suffering from antiphospholipid syndrome, then discontinuation of oestrogen therapy (either for birth control or menopause) would provide symptomatic relief.