The Lupus Connection


	Anti Phospholipid Syndrome

HUGHES SYNDROME

Up to 50% of patients with SLE have antibodies to phospholipids ('sticky blood').

SLE patients with Antiphospholipid antibodies: 40% have thrombosis.

SLE without Antiphospholipid antibodies: 12% to 18% of patients.

SLE patients have a higher incidence of cardiac valvular disease, hemolytic anemia, leukopenia and low C4 complement levels.

Hemorrhagic stroke occurs more commonly in active lupus.

Thrombotic stroke, possibly related to the Anti-phospholipid antibody, is more common in quiescent phases-(remissions).

Prevalence Of Antiphospholipid Antibodies:

Presence of antiphospholipid antibodies does not necessarily indicate an increased risk for thrombosis.
The presence of AP-As is considered a risk factor for stroke, but this association may be true only in patients with SLE or other autoimmune disorders.
Many well-controlled studies have found no association between AP-As and stroke in non-SLE patients.

Autoimmune diseases Percentage Relationships to Secondary Anti-Phospholipid Syndrome (APS)

Juvenile chronic arthritis - 55%
SLE - 15% to 50%
Sjogren's syndrome - 42%
Rheumatoid arthritis - up to 33%
Idiopathic Thrombotic Purpura - 30%
Posoriatic arthritis - 28%
Scleroderma - 25%
Mixed Connective Tissue Disease - 22%
Giant cell arteritis - 20%
Polymyalgia rheumatica - 20%
Behcet's disease - 0% to 50%

Treatment to prevent Thrombosis

Treatment of patients with APL Antibody is controversial.
The problem seems to be mainly an abnormal hyper-coagulable state that predisposes to thrombosis of arteries rather than true vasculitis.
Asymptomatic patient with Antiphospholipid Antibodies: Reduce risk factors for vascular disease.
Patients with high titers: Avoid oral contraceptive.
Life style change: Maintain ideal weight, cholesterol level and physical activity; control blood pressure and avoid smoking.

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