Antiphospholipid Syndrome
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Characteristic features
- Hypercoagulability; recurrent arterial or venous thromboses
- Thrombocytopenia is common
- Recurrent fetal loss
- Recurrent events are common; lifetime anticoagulation with warfarin is recommended.
Treatment
- Patients should be given warfarin to maintain an INR of 2.0-3.0.
- Patients who have recurrent thrombotic events while taking warfarin may require higher INRs (greater than 3.0), but the bleeding risk increases substantially with this degree of anticoagulation.
- Because of the teratogenic effects of warfarin subcutaneous heparin and low - dose aspirin (81 mg) is the usual approach to prevent pregnancy complications in women with APS
- In patients with catastrophic APS, a three - pronged approach is taken in the acute setting intravenous heparin, high doses of corticosteroids, and either intravenous immune globulin or plasmapheresis