This presentation on APLA SYNDROME will help you understand the definition, clinical features, risk factors involved, including etiology, physical examination, diagnosis and Management.
It also includes an overview on complications of APLA syndrome and prevention.
This presentation on APLA SYNDROME will help you understand the definition, clinical features, risk factors involved, including etiology, physical examination, diagnosis and Management.
It also includes an overview on complications of APLA syndrome and prevention.
Antiphospholipid antibody Syndrome (APS) by Sunil Kumar Dahasunil kumar daha
Please find the power point on Management and pathophysiology of Antiphospholipid antibody . I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Antiphospholipid Syndrome (APS) has been associated with a variety of medical problems in pregnancy;blood clots in arteries and veins (deep vein thrombosis), low platelets and both early (<12wks) and later fetal loss. http://www.vsacharmd.com
Prof hanan anti phospholipid syndrome with highlights on criteria and seronegative antiphospholipid
Head of internal medicine, faculty of medicine, Beni-Suef University
First lupus day October 2018
Antiphospholipid antibody Syndrome (APS) by Sunil Kumar Dahasunil kumar daha
Please find the power point on Management and pathophysiology of Antiphospholipid antibody . I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Antiphospholipid Syndrome (APS) has been associated with a variety of medical problems in pregnancy;blood clots in arteries and veins (deep vein thrombosis), low platelets and both early (<12wks) and later fetal loss. http://www.vsacharmd.com
Prof hanan anti phospholipid syndrome with highlights on criteria and seronegative antiphospholipid
Head of internal medicine, faculty of medicine, Beni-Suef University
First lupus day October 2018
Rheumatology Sheet from Rheumatology Department, Faculty of Medicine, Zagazig University, Egypt.
Disclaimer : not my slide. Just uploading for my personal use..
Lupus update for rhem fellows wramc 2014 talkDonald Thomas
Update about the diagnosis and management of systemic lupus erythematosus (SLE) from the past several years. This includes the SLICC revision classification criteria for SLE, importance of using ANA by immunofluorescence instead of solid assays, appearance of autoantibodies many years before SLE diagnosis, the need for using Plaquenil along with immunosuppressant medications, importance of correcting vitamin D levels, avoiding lupus triggers (UV light, tobacco, sulfa), proper dosing of Plaquenil (hydroxychloroquine), the proper screening tests for anti-malarial retinopathy, including Gardasil and Prevnar PCV-13 at important vaccines, and the use of IM steroids for flares.
The study to measure the level of serum annexin V in patients with renal hype...inventionjournals
ABSTRACT : Renovascular hypertension reflects the causal relation between anatomically evident arterial occlusive disease and elevated blood pressure. The coexistence of renal arterial vascular disease and hypertension roughly defines this type of nonessential hypertension. The aim of this study was to measure the level of serum Anti-Annexin V antibodies in patients with renal hypertension. Methods. This study was conducted on 115 patients, diagnosed with renal hypertension and hypertension. Informed consents were obtained from the patients and the study was approved by the Kharkiv National Medical University ethics committee. Ten healthy age and sex matched volunteers were included as a control group. All patients and controls were subjected to the following full history taking and thorough clinical examination. Routine laboratory testing included a complete blood count, and erythrocyte sedimentation rate (ESR) and kidney function tests (blood urea nitrogen and serum creatinine). Immunological tests for antinuclear antibody (ANA) and anticentromere antibodies (ACA) was performed by the indirect immunofluorescence technique. AntiScl-70 (anti-topoisomerase antibodies) and anticardiolipin antibodies (ACA: IgG and IgM) were tested using the ELISA technique. The anti-annexin V antibodies titre used the ZYMUTEST anti-Annexin IgG ELISA kit. [Hyphen-BioMed, France.]: to measure the IgG isotype of auto-antibodies to annexin V in human serum. Results. Anti-annexin V antibodies were present in 75% of patients (mean 83.46 ± 22.44 AU/mL) vs. 0% in the controls (mean 3.94 ± 4.5 AU/mL). Comparison between patients and controls as regards levels of anti-annexin V showed a highly significant difference (P < 0.001). Furthermore, correlation of anti-annexin V titres with the disease activity score in the patient group showed a statistically significant positive correlation (r = 0.51, P < 0.05).In addition, the anti-annexin V antibody titres in this study showed a highly significant positive correlation with ACL antibodies (r = 0.74, P < 0.001). Patients with antiphospholipid syndrome (APS) have been known to have a higher frequency of anti-annexin V antibodies, and thrombotic events have been reported more frequently in patients with positive anti-annexin V antibodies. Furthermore, inhibition of annexin V binding to negatively charged phospholipids may be an additional pathogenic mechanism of APS.
Dr. Angela Christiano presents an update on genetic and immunological studies in alopecia areata. Dr. Christiano’s research has helped clarify the immunologic mechanisms behind the disease. Now, early clinical trials with existing drugs that specifically target these mechanisms are showing promising hair regrowth. Dr. Christiano is the Richard and Mildred Rhodebeck Professor of Dermatology and Professor of Genetics & Development, and Vice Chair for Basic Science Research in Dermatology at Columbia University.
Ohio State's ASH Review 2017 - Myeloproliferative DisordersOSUCCC - James
Katherine Walsh, MD
Assistant Professor of Clinical Internal Medicine
The Ohio State University Comprehensive Cancer Center -
Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
Thrombotic Microangiopathies and AntiPhospholipid SyndromeRichard McCrory
This was a Nephrology seminar from last year on Thrombotic Microangiopathies, and I covered a small piece on Antiphospholipid Syndrome at the end. I hope it's informative!
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
CDSCO and Phamacovigilance {Regulatory body in India}
Anti phospholipid syndrome
1. Hospital based prospective longitudinal
study of 231 patients of Antiphospholipid
Syndrome and exploring the role of AntiAnnexin A5, Plasminogen Activator
Inhibitor-1 (PAI-1) and platelet dysfunction
in its pathogenesis.
Departments of Medicine, Nephrology, Obstetrics and
Gynaecology, Biochemistry and Immuno-pathology Division.
Institute of Medical Sciences, Banaras Hindu University
2. INTRODUCTION
Antiphospholipid syndrome (APS) was first described by
Graham R. V. Hughes in 1983 as a clinical syndrome
characterized
by
venous
and
arterial
thrombosis, recurrent pregnancy loss, neurological
disease and the presence of antiphospholipid
antibodies (aPLs).
Primary APS: When this syndrome occur without evidence of
another identifiable autoimmune disorders.
Secondary APS: When this syndrome occur in association with
3. The diagnosis of APS is confirmed in the presence of at least one clinical
and one laboratory criterion (modified Sapporo criteria, 2006)
Clinical Criteria1. Vascular thrombosis:
one or more venous, arterial, or small vessel thrombotic events in
any tissue or organ confirmed by imaging or histopathology .Thrombosis should be
present without any significant evidence of inflammation in the vessel wall. (superficial
vein thrombosis is not included in clinical criteria).
2. Pregnancy morbidity
One or more unexplained deaths of a morphologically normal fetus at or beyond the
10th week of gestation.
One or more premature births of a morphologically normal neonate before the 34th week
of gestation because of eclampsia, severe preeclampsia, or placental insufficiency.
Three or more consecutive spontaneous abortions before the 10th week of gestation (in
the absence of parental chromosomal causes and maternal anatomic or hormonal
abnormality).
Miyakis S, Lockshin MD et al. 2006, J Thromb Haemo 4, 295-306
4. Laboratory Criteria1.
aCL-Abs (IgG and/or IgM) present in serum or plasma on 2 or more
occasions atleast 12 weeks apart (in medium or high titer, ie, >40 GPL [IgG
phospholipid] or MPL [IgM phospholipid] units or >99th
percentile, measured by a standardized enzyme-linked immunosorbent assay
[ELISA])
2.
LA (lupus anticoagulant) present in plasma on 2 or more occasions at least
12 weeks apart (measured according to the guidelines of the International
Society on Thrombosis and Haemostasis)
3.
Anti-b2GPI antibody (IgG and/or IgM) present in serum or plasma on 2 or
more occasions at least 12 weeks apart (in titer >99th percentile, measured by
a standardized ELISA).
The diagnosis of APS cannot be confirmed if less than 12 weeks (or more than
5 years) separate the time of the positive aPL-Ab test and the time of the clinical
manifestation.
11. Table: Clinical Manifestations of 179 pts of
primary APS
CLINICAL MANIFESTATIONS
A. Venous Thrombosis
No. of Patients
Percentage %
( 33 )
( 18.4)
- Deep vein thrombosis (DVT)
19
10.6
- Cortical vein &/or sinus thrombosis
11
6.1
- Budd-Chiari Syndrome
3
1.8
(24)
(13.4)
- Peripheral arterial thrombosis
12
6.7
-Intracranial arterial thrombosis
9
5
- Visceral arterial thrombosis
3
1.7
(140)
(78.2)
- Recurrent early pregnancy losses
32
17.8
- Late pregnancy losses
97
54.2
- Premature birth/ Still birth
28
15.6
- Preeclampsia/ Eclampsia
13
7.3
B. Arterial Thrombosis
C. Adverse Pregnancy Outcome
12. Continued
CLINICAL MANIFESTATIONS
No. of Patients
Percentage
D. Neurological involvement
- Psychosis
3
1.7
- Seizure
2
1.1
2
1.1
3
1.7
- Thrombocytopenia
75
41.9
- Coombs positive hemolytic anemia
4
2.2
- Digital gangrene
7
3.9
- Livedo reticularis
6
3.3
- Chronic leg ulcer
2
1.1
E. Cardiac involvement
- Myocardial Infarction
F. Respiratory involvement
- Pulmonary Hypertension
G. Hematologic manifestations
H. Skin manifestations
13.
14.
15.
16.
17.
18.
19. Table: Immunological Parameters in 179 pts of
primary APS
Immunological tests
No. of patients
Percentage
- IgG
141
78.8
- IgM
32
17.9
- Both
29
16.2
B. Lupus Anti-coagulant
99
55.3
C. Both aCL and LA
64
35.7
A. Anti-Cardiolipin Ab (aCL) : mod-high
20.
21.
22.
23.
24.
25. Table :Treatment of APL
Clinical
condition
Treatment
Asymptomic
No treatment; short term antticoagulant if required
Venous thrombosis
Long-term anticoagulant (Heparin & warfarin); INR 2 to 3
Arterial thrombosis
L ong-term anticoagulant; INR 2 to 3 vs 3.1 to 4
+ low-dose antiplatelet (controversial)
Pregnancy morbidty
Low-dose anticoagulant (Heparin 10 to 20,000 u/day or LMWH
1u/kg/day) + Low-dose antiplatelet
If having throbotic event : As above
Catestrophic APS
Anticoagulant (INR 3 to4) + corticosterod
IV Ig/ Plasmapheresis
Others (Fibrinolytic/Cyclophosphmide/Prostacyclin etc)
26. Pathogenesis of APS
It appears to be multifactorial and multifaceted and is an area of
intense research in recent time.
1. Endothelial cell activation leading to increased expression of
2.
3.
4.
5.
6.
adhesion molecules and TF.
Displacement of Annexin A5 from endothelial cells.
Platelet activation
Activation of complement system
Inhibition of naturally occurring anticoagulants (Protein C,S
and AT-3)
Impaired fibrinolysis
Exact pathogenesis still remains inconclusive.
27.
28. Annexin A-V weight 36kd)
a glycoprotein (molecular
Ability to bind to negatively charged phospholipids with high
affinity in a calcium-dependent manner.
Forms a protective anticoagulant shield on vascular endothelial
cells
Antiß2- GPI Abs/ ß2-GPI complex disturb the shield and
predispose to placental thrombosis and fetal loss.
29.
30.
31. Baseline data of antiphospholipid syndrome (APS) patients
CLASS
IFICA
TIOn
Mean Sex
+/-S.D. (M/F)
age
(years
)
Thrombosis(n
=48)
Venous Arteri
no.(%) al no.
(%)
Primar
y APS
(n=86
Bad obstetric history
(n=64)
(Early
Pr.loss)
(<10 wk
%)
ACLA
IgG>2
0 GPL
LA no.
(%)
(Late
Others
pr. loss No. %
(>10wk
%)
27 +/4.33
6/80
19
(22.05)
11
13
(12.79) (15.11)
33
(38.37)
7
(10.93)
77
45
(89.53) (52.32)
Second 28.5
ary
+/-6.9
APS
(n=26
3/23
9
(34.61)
9
4
(34.61) (15.38)
5
(19.23)
2
(7.69)
23
14
(88.46) (53.84)
Total
(n=112)
9/103
28
20
(25.00) (17.85)
17
(15.17)
9
(8.03)
100
59
(89.28) (52.67)
27.75
+/-
20
(17.85)
32. Estimation of Anti – annexin A-V
Antibody levels were measured by quantitative
enzyme-linked immunosorbent assay (ELISA),
using the Zymutest kit
39. CONCLUSION
The present study revealed significantly higher
positivity rates and significantly raised levels of aANX
IgG in primary as well as secondary APS patients as
compared to healthy controls (P < 0.001).
However, it did not differ significantly between
healthy controls and patients with SLE, RA, non-APS
thrombosis and non- APS pregnancy complications.
Furthermore, the level of aANX IgG was significantly
higher in subsets of APS patients having bad obstetric
history and/or thrombosis (P < 0.001).
40.
41. Role Of Impaired Fibrinolysis In APS
Relatively understudied, few recent reports suggest that
deficient fibrinolysis may contribute to hypercoagulable
state in APS.
43. Estimation of PAI-1Ag
Estimation of PAI-1Ag was done by quantitative ELISA,
using the Zymutest kit according to the manufacturer’s
instructions (Hyphen Biomed)..
49. Conclusion
Level of PAI-1Ag was higher in APS patients in relation to
control groups.
Significantly higher proportion of prim. and sec. APS
patients showed positivity in relation to healthy controls
(p=0.006 & 0.001 respectively).
Mean±SEM levels of PAI-1Ag were significantly higher in APS
patients (p<0.001) but didn’t differ in 3 control groups.
50.
51.
52. Platelet function studies included :
Freshly prepared 1.4 ml of citratephosphate-
dextrose anticoagulant (CPDA) was added to
blood.
Platelet rich plasma (PRP) was separated from
the samples and were analysed within 3 hours.
The laboratory personnel were blinded to the
source of samples.
53. The following platelet function studies were performed:
1. Platelet aggregation studies
2. Studies pertaining to platelet secretion of dense
granules, which comprised of :
• Total degranulation
• Platelet secretion of granules in relation to time
• Visualisation of platelet degranulation and alteration of its
morphology by phase contrast microscopy
3. Clot retraction studies by tube method
4. Western blot studies on clot retracted samples for
demonstration of activated proteomes
54. RESULTS
A significant increase (P < 0.001) in the platelet aggregation in
APS patients as compared to healthy controls was noted.
The subjects also showed a significant increase (P < 0.05) in the
platelet granule release as well as more degranulation (P < 0.001)
in relation to time at stored condition, which were well-visualized
under phase-contrast microscope.
Sixty-five percent of APS patients showed lesser as well as delayed
clot retraction as compared to healthy controls, signifying that the
platelet clots are less retractile in APS patients.
60. Western blot of clot retracted samples of control and
APS patients showing additional bands at 37 kDa of
anti-phosphotyrosine antibodies
61. CONCLUSION
In-vitro studies on platelets from APS patients, revealed:
1. Significantly increased platelet aggregation.
2. Increased degranulation of platelets.
3. Poor clot retraction and
4. Additional band of 37kDa of anti-phosphotyrosine
antibodies in APS patients by Western Blot study
Thus, platelets seem to play an important role in formation of
occlusive clot in vessels in APS patients.
62. Pathogenic Mechanisms of APS
Endothelial Cells
Activation
Platelet
Activation
Expression of adhesion molecules and TF
Raised pro-inflammatory cytrokines
Antiannexin A5
antibodies
Anti-Phospholipid Syndome
Antiphospholipid antibodies
Impaired
Fibrinolysis
Inhibition of Natural
Anti-coagulants
Activation of
complement
system
63. LEARNING POINTS: Anti Phospholipid Syndrome (APS) is a leading cause of venous and/or arterial
thrombosis as well as adverse pregnancy outcomes such as early (<10 weeks)
and late pregnancy losses, preterm labor, IUGR, still birth and toxemia of
pregnancy.
High index of clinical suspicion is necessary as clinical presentation varies
widely.
When clinically suspected, laboratory confirmation should be done by IgG
anticardiolipin antibody (ACLA), Lupus Anticoagulant (LA) and β2GP-1. All 3
tests should be done because in a given patient any one of them may be
positive.
Pathogenesis of APS appears to be multi-factorial and complex and is an area of
ongoing research and investigation. Studies establishes the role of antiannexinA5, plasminogen activator inhibitor 1 (PAI-1) and hyperactivity of
platelets in the pathogenesis of APS.