Rheumatology

Antiphospholipid Syndrome

Questions discussed in this category

Would you start anticoagulation in a patient with a history of CVA 1 year ago and high risk APL profile who was never started on anticoagulation, but is now presenting for follow up and without recurrent thrombotic events?

The patient has no known history of autoimmune disease.

4 Answers available

How do you interpret elevations in antiphospholipid antibodies that are lower than Sapporo criteria?

(e.g. beta 2 glycoprotein IgM > 20 but <40)

2 Answers available

Would you discontinue anticoagulation in patients with antiphospholipid antibody syndrome, who have a remote history of thrombotic events and are now negative for pathogenic antiphospholipid antibodies?

Would the answer differ if the index event was arterial vs venous?

3 Answers available

Do you repeat antiphospholipid antibody testing in a patient that previously met criteria for APLS?

If so, how long after diagnosis do you do so?

1 Answer available

Do you find IgA isotypes of anti-beta2-glycoprotein antibodies and anticardiolipin antibodies to be clinically useful in the evaluation for APS?

Do you routinely check IgA anticardiolipin and beta-2 glycoprotein antibody IgA in your practice? And how would a positive result change your manageme...

2 Answers available

Do you ever consider treatment outside of the peripartum period in a patient with a history of obstetric APS?

i.e. obstretric APS without thrombosis or SLE

2 Answers available

Is there a role for immunosuppression in patients with triple positive antiphospholipid antibodies who do not meet the clinical criteria for APS?

2 Answers available

What is your preferred approach for patients with anti-phospholipid syndrome with recurrent thrombosis on coumadin and LMWH?

1 Answer available

What is your approach to a patient with positive antiphospholipid antibodies who otherwise do not meet clinical criteria for APS?

What if the patient is triple-positive or has continued seropositivity on repeat lab testing? What is the appropriate interval of monitoring and does ...

3 Answers available

Do you recommend COVID vaccination in patients with antiphospholipid antibody positivity or other prothrombotic states not on anti-coagulation?

1 Answer available

Do you consider low-dose aspirin for primary thromboprophylaxis in patients with high-risk antiphospholipid antibody profiles?

While low-dose aspirin for primary thrombosis prevention in aPL without APS is not typically recommended outside cardiovascular prevention guidelines ...

1 Answer available

How do you approach the use of low-dose aspirin for primary prevention in non-pregnant patients with SLE and positive aPL antibodies, without clinical criteria for APS?

Do you follow the 2019 EULAR Guidelines that SLE patients with asymptomatic, positive aPL should be on low-dose ASA?

1 Answer available

Do you check pertussis serologies when sending labs for antiphospholipid syndrome?

2 Answers available

How do you approach anticoagulation in patients with catastrophic antiphospholipid syndrome and thrombocytopenia?

1 Answer available

Which patients may benefit from eculizumab in refractory APS?

2 Answers available

Is there any role for direct oral anticoagulants in the treatment of antiphospholipid syndrome?

What if this was "triple-negative" antiphospholipid syndrome?

2 Answers available

For which subset(s) of APS patients do you recommend an INR of 3 or higher?

1 Answer available

Papers discussed in this category

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, 2016-04

Apixaban for the Secondary Prevention of Thrombosis Among Patients With Antiphospholipid Syndrome: Study Rationale and Design (ASTRO-APS).

Blood, 2018 Jul 12

Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome.

Ann. Intern. Med., 2019 Oct 15

Rivaroxaban Versus Vitamin K Antagonist in Antiphospholipid Syndrome: A Randomized Noninferiority Trial.

Annals of the rheumatic diseases, 2019-10

EULAR recommendations for the management of antiphospholipid syndrome in adults.

Diagnosis and Management of the Antiphospholipid Syndrome.

Clinical immunology (Orlando, Fla.), 2019-09

Treatment of antiphospholipid syndrome beyond anticoagulation.

Seminars in arthritis and rheumatism, 2019-08

Secondary thrombotic microangiopathy in systemic lupus erythematosus and antiphospholipid syndrome, the role of complement and use of eculizumab: Case series and review of literature.

Journal of thrombosis and haemostasis : JTH, 2018-06-07

McMaster RARE-Bestpractices clinical practice guideline on diagnosis and management of the catastrophic antiphospholipid syndrome.

Ann Rheum Dis,

Antiphospholipid antibodies and infections.

Journal of the American Society of Nephrology : JASN, 1993-07

Reversible renal failure in the primary antiphospholipid syndrome--a report of two cases.

Arthritis and rheumatism, 2013-02

A pilot open-label phase II trial of rituximab for non-criteria manifestations of antiphospholipid syndrome.

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2014-02

Eculizumab prevents recurrent antiphospholipid antibody syndrome and enables successful renal transplantation.

Lupus, 2018-03

Hydroxychloroquine in the primary thrombosis prophylaxis of antiphospholipid antibody positive patients without systemic autoimmune disease.

Lupus,

16th International Congress on Antiphospholipid Antibodies Task Force Report on Antiphospholipid Syndrome Treatment Trends.

Arthritis Rheum,

Risk factors for thrombosis and primary thrombosis prevention in patients with systemic lupus erythematosus with or without antiphospholipid antibodies.

Rheumatology (Oxford), 2021 May 18

Cognitive dysfunction and associated neuroimaging biomarkers in antiphospholipid syndrome: a systematic review.

Am J Transplant, 2013 Jun 13

Eculizumab improves posttransplant thrombotic microangiopathy due to antiphospholipid syndrome recurrence but fails to prevent chronic vascular changes.

Thromb Res, 2021 Jun 25