Antiphospholipid Syndrome

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