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Antiphospholipid Syndrome (Internal Medicine)

Thrombotic and obstetric autoimmune disease: contemporary anticoagulation strategy

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Antiphospholipid Syndrome (Internal Medicine)?

APS is one of the most common acquired thrombophilias; the female:male ratio is 5:1, peak incidence is in the 20-50 age range. Estimated to be responsible for 10-15% of recurrent miscarriages and 20% of strokes in young patients. Primary (alone) or secondary (in connection with SLE/other autoimmune disease) forms exist.

Pathogenesis: Antibodies binding to phospholipid-protein complexes (β2 glycoprotein I, prothrombin, annexin V) trigger thrombosis through endothelial dysfunction, platelet activation, complement activation, and tissue factor expression.

Diagnosis (Sapporo/Sydney criteria): 1+ clinical (vascular thrombosis or pregnancy morbidity) + 1+ laboratory (positivity of antibodies on two occasions ≥12 weeks apart). Triple positivity (LA + aCL + anti-β2GPI) carries the highest thrombosis risk; recurrence rate is 5-10%/year.

Symptoms

Deep vein thrombosis (DVT) and pulmonary embolism
Stroke and TIA (especially in young patients)
Recurrent miscarriage (≥3, before 10 weeks)
Preeclampsia and IUGR (intrauterine growth restriction)
Livedo reticularis (skin)
Thrombocytopenia (mild-moderate)

Risk Factors

Female gender (5:1 predominance)
Reproductive age (20-50)
Coexistence with SLE (30-40%)
Triple antibody positivity (highest risk)
Smoking, hypertension, hyperlipidemia
Pregnancy and oral contraceptive use

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Idiopathic DVT/PE in young patients (<50)
  • Stroke or TIA in young patients (<55)
  • Recurrent miscarriages (≥3)
  • Severe preeclampsia or IUGR history
  • Persistent unexplained thrombocytopenia
  • Family history of APS or recurrent thrombosis

Treatment Methods

01
Long-term warfarin (INR 2-3) - secondary prophylaxis after thrombosis
02
INR 3-4 (after arterial thrombosis or recurrence)
03
LMWH + low-dose aspirin (in pregnancy)
04
Hydroxychloroquine (in association with SLE)
05
Catastrophic APS: triple therapy (anticoagulation + steroid + plasmapheresis/IVIG)
06
Cardiovascular risk control (smoking cessation, lipid management)

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.