What Is Antiphospholipid Syndrome?

Antiphospholipid syndrome (APS) is an autoimmune disease in which blood clots form in the veins and arteries. These clots, or thromboses, can develop in the brain, lungs, legs, and other organs, which can lead to conditions such as heart attack or stroke . Although there’s no cure, medications such as blood thinners can help prevent clots from forming.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295435fdb2-929c-4691-bedb-103dcde742f6e60dc2a1-f33c-4a05-9b50-8e3e8e597629b12b9c60-0e6a-4ea0-bf27-d6881e258e76
Overview Overview What Is Antiphospholipid Syndrome? Antiphospholipid syndrome is a disease in which the body’s immune system mistakenly produces antibodies that attack certain parts of cells called phospholipids.e60dc2a1-f33c-4a05-9b50-8e3e8e597629426ff39f-a78c-49ca-b04f-732e050a6cd6 When these phospholipids become damaged, blood clots can develop in the veins or arteries, leading to a stroke or heart attack . It can also lead to miscarriages, stillbirth, or other pregnancy complications, such as preeclampsia .e60dc2a1-f33c-4a05-9b50-8e3e8e597629426ff39f-a78c-49ca-b04f-732e050a6cd6 Antiphospholipid syndrome, which is also sometimes known as antiphospholipid antibody syndrome, “sticky blood syndrome,” or Hughes syndrome, is a leading cause of stroke in younger people under age 50.e60dc2a1-f33c-4a05-9b50-8e3e8e597629426ff39f-a78c-49ca-b04f-732e050a6cd6e60dc2a1-f33c-4a05-9b50-8e3e8e5976295621b83f-7b95-4a8f-b5e2-9ab4296cc3fa
Signs and Symptoms of Antiphospholipid Syndrome Symptoms Some people with high levels of these antibodies never develop symptoms. In other cases, some signs of antiphospholipid syndrome may not be detected until a person experiences problems such as a miscarriage or heart attack.e60dc2a1-f33c-4a05-9b50-8e3e8e59762978babcad-7384-4d19-b88c-a1b9075e9aac The signs and symptoms that may appear include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629dfbcbe3f-1af0-420b-ba2c-ffceeda252e9e60dc2a1-f33c-4a05-9b50-8e3e8e597629297d930f-713a-4ca7-963f-87587e6e63ad Blood clots (especially in the legs) Low blood platelet levels Anemia Purplish skin discoloration that looks blotchy or lacey (livedo reticularis) Skin ulcers Repeated miscarriages, stillbirths, or premature delivery Preeclampsia during pregnancy Heart disease Stroke The symptoms of a blood clot include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629dfbcbe3f-1af0-420b-ba2c-ffceeda252e9e60dc2a1-f33c-4a05-9b50-8e3e8e597629297d930f-713a-4ca7-963f-87587e6e63ad Chest pain Shortness of breath Nausea Pain, redness, or swelling in the arm or leg Frequent headaches Discomfort in the arms, back, neck, or jaw Abdominal pain
Causes and Risk Factors of Antiphospholipid Syndrome Causes It’s not known exactly what causes antiphospholipid syndrome, although certain gene variants have been linked to the condition. These variants may then prompt certain people to produce abnormal antibodies — specifically, the three antibodies lupus anticoagulant, anticardiolpin, and anti-B2 glycoprotein 1 — that then cause antiphospholipid syndrome.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c04fa52f-ccfa-443f-9f2a-17370f55b0ca APS is thought to be caused by a combination of genetic factors and environmental exposure, such as to a virus. In most cases, APS impacts people who have no family history of the disease, though there have been rare cases of APS occurring in multiple members of a family.e60dc2a1-f33c-4a05-9b50-8e3e8e597629dd6a757f-6306-465b-8524-5888068b751d Antiphospholipid syndrome is more common in women than men. People with autoimmune and rheumatic diseases , such as lupus , are also more likely to have the condition.e60dc2a1-f33c-4a05-9b50-8e3e8e59762962962ea8-4651-4643-9d40-a904b8492407e60dc2a1-f33c-4a05-9b50-8e3e8e59762953da7ff0-8ac1-4bb8-b62b-0d0af960109a
How Is Antiphospholipid Syndrome Diagnosed? Diagnosis If your doctor suspects you may have antiphospholipid syndrome, you may be given blood tests to check for the antibodies associated with the condition. To be given a diagnosis, you must test positive for the antibodies more than once, in tests given at least 12 weeks apart.e60dc2a1-f33c-4a05-9b50-8e3e8e597629de288c64-78ae-456e-bfa2-47a9e5651cb0 Even if you test positive for the antibodies, however, you may not have antiphospholipid disorder, particularly if you’re not experiencing related conditions such as blood clots or frequent miscarriages.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297c050e24-ee68-40af-b0fe-e49389a6b772
Treatment and Medication Options for Antiphospholipid Syndrome Treatment Antiphospholipid syndrome is typically treated with medications called blood thinners (anticoagulants and antiplatelets), which can help slow down or prevent blood clots from forming. Common medications used to treat APS include warfarin (Coumadin) and aspirin.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295faa3e0f-94d1-4d46-b5bf-ed34205e697de60dc2a1-f33c-4a05-9b50-8e3e8e5976292ac03e47-24de-4fee-9d09-9531ce9c8b69 In the case of an acute blood clot (which needs immediate medical attention because the clot can potentially travel to the lungs, blocking blood flow), an injection of heparin (an anticoagulant) may be given in the hospital.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295faa3e0f-94d1-4d46-b5bf-ed34205e697d Since untreated antiphospholipid syndrome can increase the risk of miscarriage during pregnancy, pregnant people may be given low-dose aspirin as well as injections of enoxaparin (an anticoagulant) to prevent fetal loss. In more serious cases of recurrent miscarriages, doctors may recommend corticosteroids such as prednisone or intravenous immunoglobulin infusions.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295faa3e0f-94d1-4d46-b5bf-ed34205e697d In some cases, such as when blood thinners are not effective in treating APS, doctors may turn to targeted immunosuppressants such as rituximab and eculizumab to treat APS, though more research is needed to determine the effectiveness of these medications in managing APS.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e911aaf3-3c22-4512-8c82-5b261a5e6438 Some other drugs that are used to treat APS include hydroxychloroquine (a malaria medication that’s long been used to treat rheumatic diseases)e60dc2a1-f33c-4a05-9b50-8e3e8e5976298a7a1f62-43f4-492f-ab03-6b098c2ef344 and statins (cholesterol-lowering medications that may have anti-inflammatory and anticoagulant effects in people with APS).e60dc2a1-f33c-4a05-9b50-8e3e8e597629df232a75-e669-4e37-9260-ef1c164eed77
Prevention of Antiphospholipid Syndrome Prevention There’s no cure for antiphospholipid syndrome, and it’s not possible to prevent the disorder. But by taking medication and making certain lifestyle changes, you can reduce the risk of blood clots.e60dc2a1-f33c-4a05-9b50-8e3e8e59762903a1a4a8-9ba2-45da-bdf6-ae6b8bc29475 Engaging in regular exercise, eating a healthy diet, and practicing other health-promoting habits can reduce your risk of high blood pressure and diabetes , which can increase your risk for stroke.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291e3a000e-ad71-47c7-925c-1d085763de6e
Lifestyle Changes for Antiphospholipid Syndrome Lifestyle Changes If you’re taking blood thinners to prevent blood clots, you may need to make certain changes to your lifestyle to reduce the risk of bleeding. These may include avoiding sports or activities that could cause bruising or injury, and using caution around sharp tools, such as knives or scissors. Certain supplements and medications can also interfere with anticoagulants such as warfarin. You may also need to avoid or cut back on alcohol, which can increase the effect of blood-thinning medications.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a3d75ab5-c90c-4745-a063-634ea58fc439 Foods that are high in vitamin K (which is important for blood clotting) can interfere with medications such as warfarin, so you’ll want to avoid eating large amounts of vitamin K-rich foods such as:e60dc2a1-f33c-4a05-9b50-8e3e8e597629a3d75ab5-c90c-4745-a063-634ea58fc439e60dc2a1-f33c-4a05-9b50-8e3e8e5976291e06f9ae-4d2d-4eca-a581-0a95ba33d2a2 Avocado Broccoli Brussels sprouts Cabbage Leafy greens Garbanzo beans Some supplements and medications that may interfere with warfarin include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976291e06f9ae-4d2d-4eca-a581-0a95ba33d2a2 Certain pain relievers Certain cold medicines Some stomach remedies Turmeric Multivitamins Garlic Ginkgo Green tea Your doctor may also advise you to take steps that would lower your risk of blood clots, which may include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629a3d75ab5-c90c-4745-a063-634ea58fc439 Maintaining a healthy A1C level , if you have diabetes Managing your blood pressure Keeping your cholesterol levels down Losing weight, if you have obesity Stopping smoking Avoiding estrogen therapy
Antiphospholipid Syndrome Prognosis Prognosis and Outlook With treatment and healthy lifestyle habits, people with antiphospholipid syndrome can expect to live generally healthy lives. Some studies have shown that antiphospholipid syndrome is associated with up to a 94 percent survival rate after 10 years.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fc9af798-fd88-457b-ba02-7a673077979d The condition can cause permanent health problems, however: Research has found that more than 30 percent of people with the condition experience organ damage and more than 20 percent have serious complications that include pulmonary hypertension (high blood pressure in the lungs) and impaired kidney function after 10 years.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fc9af798-fd88-457b-ba02-7a673077979d
Complications of Antiphospholipid Syndrome Complications Antiphospholipid syndrome can cause blood clots, which can lead to stroke and other heart problems, as well as pregnancy complications such as miscarriage and stillbirth.e60dc2a1-f33c-4a05-9b50-8e3e8e597629129ab46d-6577-4501-b2ee-d0e04878f3a7 In rare cases (fewer than 1 percent), people with the condition can also experience a complication called catastrophic antiphospholipid syndrome (CAPS), which can be fatal in more than half of all cases. This occurs when blood clots develop in multiple blood vessels in the body, blocking blood flow and causing organ failure, typically in the kidneys, lungs, brain, heart, and liver.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292af3da4b-6c79-4a8d-91e2-d3682d3fec17
Research and Statistics: How Many People Have Antiphospholipid Syndrome? Research and Statistics Antiphospholipid syndrome is believed to affect about 1 in every 2,000 people in the United States. The disorder impacts more women than men: As many as 75 to 90 percent of those affected by APS are women.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293586da77-0805-4526-a2f8-acf8b69bd6dd One out of five women who have a history of recurrent miscarriages have antiphospholipid syndrome.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293586da77-0805-4526-a2f8-acf8b69bd6dd
Related Conditions of Antiphospholipid Syndrome Related Conditions About 40 percent of people with lupus (systemic lupus erythematosus) also have antiphospholipid syndrome.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299cab54ab-0bfc-4a5a-941a-fa73d1e5b204
The Takeaway Antiphospholipid syndrome (also known as APS) is an autoimmune disease in which the immune system mistakenly attacks certain parts of cells in the body, which can eventually lead to blood clots. The condition can lead to stroke or heart attack, as well as pregnancy complications that include preeclampsia and miscarriage. Although there’s no cure, antiphospholipid syndrome can often be managed successfully by taking blood thinner medication.
Resources We Trust Cleveland Clinic: Antiphospholipid SyndromeMayo Clinic: Antiphospholipid SyndromeNational Heart, Blood, and Lung Institute: Antiphospholipid SyndromeAmerican College of Rheumatology: Antiphospholipid SyndromeMedlinePlus: Antiphospholipid Syndrome