Antiphospholipid Syndrome
Antiphospholipid syndrome is a malady wherein the immune system incorrectly produces antibodies against certain normal proteins present in the blood. Antiphospholipid syndrome therefore can lead to formation of blood clots along the arteries or veins and can cause pregnancy related complications.
Manifestations
Signs and symptoms of antiphospholipid syndrome may include:
- Blood clots in the legs (deep vein thrombosis) that may pass through to the lungs (pulmonary embolism)
- Preeclampsia
- Stroke
- Repetitive miscarriages or stillbirths
- Complications of pregnancy (premature delivery)
- Neurological symptoms:
- Dementia
- Seizures
- Chronic headaches
- Migraines
- Rash
- Movement disorder
- Cardiovascular disease
- Sudden hearing loss
- Mental health problems (depression or psychosis)
- Bleeding
- Cognitive problems
Classifications
There are two classifications of antiphospholipid syndrome:
- Primary Antiphospholipid Syndrome – there is no underlying cause specifically an autoimmune disorder (systemic lupus erythematosus)
- Secondary Antiphospholipid syndrome – if the patient has lupus or another autoimmune disorder, the antiphospholipid syndrome is considered under the secondary classification.
Causes
The cause of primary antiphospholipid syndrome is idiopathic or is unknown. However, there are factors that can be related into having antiphospholipid antibodies.
- Infections
- Hepatitis C
- Malaria
- Syphilis
- HIV infection
- Medications.
- High blood pressure medication (hydralazine)
- Anti-seizure medication (phenytoin)
- Antibiotic (amoxicillin)
- Heart rhythm-regulating medication (quinidine)
- Genetic predispositions
Complications
Antiphospholipid syndrome may lead to the formation of blood clots in the legs and may lead to the following complications:
- Pregnancy complications – may include stillbirths, premature delivery, miscarriages and preeclampsia
- Deep vein thrombosis (DVT) – blood clots in the legs
- Stroke – results from decreased blood flow to a part of the brain
- Kidney failure- results from decreased blood flow to the kidneys.
- Cardiovascular problems
- Lung problems – may include high blood pressure in the lungs (pulmonary hypertension) and pulmonary embolism.
Assessment and Diagnosis
Blood tests for antiphospholipid syndrome need to have at least one of the following three antibodies in your blood:
- Beta-2 glycoprotein I (B2GPI)
- Lupus anticoagulant
- Anti-cardiolipin
To substantiate a diagnosis of antiphospholipid syndrome, the antibodies must appear in the blood test at least twice with at least 12 weeks apart.
Management
The management of antiphospholipid syndrome focuses on the prevention of blood clot formation caused by the abnormal changes in the immune system.
- Standard initial treatment
- Use of a combination of anticoagulant (blood-thinning) medications.
- Heparin
- Warfarin
- Aspirin
- Stop smoking – instruct patient to avoid or stop smoking cigarettes
- Control cholesterol intake – instruct patient to plan diet and daily meals; it is necessary that the food taken in has a low cholesterol level
- Reduce fat intake – diet plan should avoid high fat food choices
Byron Webb Romero, RN, MSN
Finished BSN at Lyceum of the Philippines University, and Master of Science in Nursing Major in Adult Health Nursing at the University of the East Ramon Magsaysay Memorial Medical Center. Currently working at Manila Doctors College of Nursing as a Team Leader for Level I and II, Lecturer for Professional Nursing Subjects, and also a Clinical Instructor.
