Causes of antiphospholipid syndrome
In antiphospholipid syndrome, the body produces antibodies against phospholipids, a type of phosphorous-containing fat molecule that's found quite normally throughout the body, particularly in the membranes surrounding each cell. Although the syndrome was first identified in patients with another condition called systemic lupus erythematosus (SLE or lupus), it's now realised that most people with antiphospholipid syndrome don’t have SLE. However, there does seem to be some overlap in a small group of people between antiphospholipid syndrome and other autoimmune diseases such as SLE or Sjögren’s syndrome.
Who's affected by antiphospholipid syndrome?
People of any age and gender can be affected, although it's more common among women. As the effects of antiphospholipid syndrome become better understood, it's increasingly thought that as many as one per cent of the population may have some aspect of the condition. As a result it has been described as 'one of the new diseases of the late 20th century'.
Diagnosis of antiphospholipid syndrome
Blood tests are a good guide for diagnosis, but not totally reliable and so are used in combination with the patient's history. A simple blood test is used to detect the antiphospholipid antibodies (also known as anticardiolipin antibodies).
This test is positive in about 80 per cent of cases. Another test, confusingly called a lupus anticoagulant test (it's not a test for lupus), is also used to help confirm the diagnosis and this is positive in about 30-40 per cent of cases.
Blood tests should also be repeated as harmless antiphospholipid antibodies can be detected in the blood for brief periods (linked to infections and medications for example) giving false positive results for antiphospholipid syndrome. The Sapporo criteria is a classification method used by researchers, which defines antiphospholipid syndrome based on a combination of clinical and laboratory criteria.
Treatment of antiphospholipid syndrome
Treatment is simple and aimed at preventing the formation of clots or thrombus using aspirin or heparin, or both.
Only a low dose of aspirin is needed (75mg a day, which is about one quarter of an adult aspirin tablet).
A woman's chance of carrying a baby to term may be increased from 19 up to 75-80 per cent if aspirin is taken regularly and a heparin injection also given. Heparin doesn't cross the placenta and isn't known to cause any harm to the foetus, although long-term use may be linked to osteoporosis in the mother (newer low molecular weight heparin may cause fewer problems).
Once a thrombosis has occurred, warfarin is usually given. However, this treatment must be monitored and can't be given in pregnancy.
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