Antiphospholipid syndrome (also known as APS, antiphospholipid antibody syndrome or Hughes syndrome) is an autoimmune disorder in which your body’s immune system attacks proteins bound to phospholipids, a certain kind of fat found in all of the cells in your body. These antibodies make it much more likely that you will have blood clots in your arteries or veins, miscarriages and/or other pregnancy complications, such as preeclampsia.
What are the symptoms of antiphospholipid syndrome?
Symptoms and signs of antiphospholipid syndrome can include:
Having a lace-like reddish or purplish pattern on your skin (livedo reticularis).
Having heart valve abnormalities.
Antiphospholipid syndrome most commonly causes blood clots. The symptoms of having a blood clot depend on where the blood clot is in your body. Symptoms and signs of having blood clots can include:
Having chest pain and shortness of breath.
Experiencing pain, redness and swelling in your arm or leg.
Experiencing frequent headaches.
Experiencing discomfort in your arms, back, neck and/or jaw.
Abdominal pain.
It’s important to contact your healthcare provider immediately or go to the nearest hospital if you are experiencing signs and symptoms of a blood clot. Blood clots can be deadly.
What causes antiphospholipid syndrome?
Antiphospholipid syndrome is an autoimmune disorder. It develops when your body’s immune system mistakenly makes antibodies that attack phospholipid-binding proteins in your cells. Researchers are unsure what exactly causes your immune system to suddenly attack its own blood proteins, but healthcare professionals think it has to do with genetic mutations and environmental factors.
How is antiphospholipid syndrome treated?
The main goal of treatment for antiphospholipid syndrome is to prevent further episodes of the medical conditions it is causing, whether that’s blood clots and/or miscarriages.
Blood thinners (anticoagulants) are generally used to prevent blood clots. Blood thinner medications that people with antiphospholipid syndrome may use include:
IV heparin: If an individual is experiencing an acute blood clot, they will be given an IV of heparin, an anticoagulant, in the hospital.
Oral warfarin (Coumadin): This blood thinner is a pill that is taken to prevent blood clots. People who have antiphospholipid syndrome often need to take an oral blood thinner for long periods of time.
Aspirin: People with antiphospholipid syndrome who have had a blood clot in an artery may take aspirin, which can help prevent blood clots.
Individuals who have experienced recurrent miscarriages and who have been diagnosed with antiphospholipid syndrome may take the following medications to prevent another miscarriage and to deliver a healthy baby:
Enoxaparin injections and low-dose aspirin: Enoxaparin shots and low-dose aspirin are the standard treatment for preventing miscarriages for people who have antiphospholipid syndrome. The combination therapy starts at the beginning of the pregnancy and continues in the period immediately after the delivery of the baby.
IV immunoglobulin infusions: In more difficult cases of recurrent miscarriage, IV immunoglobulin infusions might be used. Immunoglobulin infusions are used to treat immune system disorders.
Corticosteroids (prednisone): In more difficult cases of recurrent miscarriage, corticosteroids such as prednisone or prednisolone might be used.
Are there side effects of the medication used to prevent blood clots?
Taking blood thinners (anticoagulants) increases your chances of bleeding internally and externally. Your healthcare provider will check your dosage with blood tests to make sure your blood will be able to clot enough if you get a cut or a bruise.
It is important to know the warning signs of bleeding issues when you are taking blood thinners. Contact your healthcare provider right away if you experience any of the following symptoms:
Having unexplained bleeding from your gums and/or nose.
Having a heavier menstrual period than normal.
Having vomit that is bright red or looks like coffee grounds.
Experiencing bright red blood in your poop or having black, tarry poop.
Experiencing pain in your abdomen or severe head pain.
Experiencing sudden changes in your eyesight.
Experiencing a sudden loss of movement in your arms and/or legs.
Are the medications used to prevent miscarriages safe?
The treatment therapy of heparin and low-dose aspirin for pregnant people who have antiphospholipid syndrome is safe and effective for both the parent and the baby.
Is there a cure for antiphospholipid syndrome?
There is currently no cure for antiphospholipid syndrome. However, treatment in the form of medication can help prevent the medical conditions antiphospholipid syndrome can cause, including blood clots and miscarriages.
How is antiphospholipid syndrome diagnosed?
Antiphospholipid syndrome is diagnosed through more than one blood test that checks for antiphospholipid antibodies. This test is usually only taken by people with blood clots and/or individuals who are experiencing recurrent (frequent) miscarriages. Some people can have antiphospholipid antibodies and never experience a blood clot.
The screening for antiphospholipid syndrome requires three kinds of blood tests to check for antiphospholipid antibodies. Each individual test cannot find all of the possible antibodies, so the tests are often all used together. At least one of the three types of blood tests must be positive two different times three months or more apart in order for the person to be diagnosed with antiphospholipid syndrome.
Some people have antiphospholipid antibodies but never have signs or symptoms of the syndrome. Just because you have the antibodies doesn't mean that you have antiphospholipid syndrome. To be diagnosed with antiphospholipid syndrome (APS), you must have APS antibodies in addition to a history of health problems related to the disorder, such as blood clots and/or frequent miscarriages.
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