BETTER UNDERSTANDING LUPUS AND ITS ISSUES

What is the antiphospholipid syndrome?

Antiphospholipid (antibody) syndrome (APS) is an autoimmune "disease" characterised clinically by the occurrence of blood clots or miscarriages, and biologically by the presence of antibodies to phospholipids. These antibodies will activate clotting and lead to the appearance of blood clots (thrombosis), which can be located in all the vessels of the body: arteries of the brain, kidney, heart ... or veins of the limbs, neck, liver... Depending on the type and place where the vessel is clogged, the symptoms will be different (but the mechanism is the same).

APS can be either isolated (called primary APS) or associated with another systemic autoimmune disease, essentially lupus (this is called associated APS).

In pregnant women, these antibodies can clog the vessels of the placenta, thus reducing the exchanges between mother and child, and cause repeated miscarriages.

While it is difficult to make antiphospholipid antibodies disappear, it is quite simple to fight against their effects, giving anticoagulant drugs (aspirin depending on the situation). These drugs, when taken as prescribed, make it possible to carry out a normal pregnancy.

Anticoagulants are to be taken in the long run in case of a history of phlebitis or arterial clot.

Apart from pregnancy, it is important to know, that during lupus, the presence of antiphospholipid antibodies increases the risk of blood clots. In this case, doctors can sometimes offer small doses of aspirin for preventive purposes.

Hydroxychloroquine prescribed for lupus also has positive effects on the risk of clots induced by the presence of antiphospholipid antibodies

Takeaways

Antiphospholipid antibody syndrome (APS) is an autoimmune disease that causes clots due to antiphospholipid antibodies. APS can be isolated (primary APS) or integrated with another systemic autoimmune disease, primarily lupus (secondary or associated APS). The treatment of APS is mainly based on very prolonged anticoagulant treatment or aspirin together with subcutaneous heparin in case of pregnancy-related occurrence only.

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