Materiały źródłowe

• #1

  https://www.nhs.uk/conditions/antiphospholipid-syndrome/symptoms/

  In antiphospholipid syndrome (APS), the immune system produces abnormal antibodies that make the blood „stickier” than normal. […] This means people with APS are more likely to develop blood clots in their veins and arteries, which can cause serious or life-threatening health problems. […] People with APS may also experience any of the following symptoms: balance and mobility problems, vision problems, such as double vision, speech and memory problems, a tingling sensation or pins and needles in your arms or legs, fatigue (extreme tiredness), repeated headaches or migraines. […] Women with APS have a much higher risk of developing complications during pregnancy, particularly if it’s not treated. […] Possible complications include recurrent (3 or more) early miscarriages, usually during the first 10 weeks of pregnancy, 1 or more later miscarriages, usually after week 10 of pregnancy, premature birth, usually at or before week 34 of pregnancy, which may be caused by pre-eclampsia.

• #2

  https://www.nhs.uk/conditions/antiphospholipid-syndrome/

  Antiphospholipid syndrome (APS), sometimes known as Hughes syndrome, is a disorder of the immune system that causes an increased risk of blood clots. […] Some people have general symptoms that can be similar to those of multiple sclerosis (a common condition affecting the central nervous system), such as tiredness or numbness and tingling in different parts of the body. […] But a small number of people with APS continue to experience blood clots despite extensive treatment.

• #3 Antiphospholipid Antibody Syndrome (APS) | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/a/antiphospholipid-antibody-syndrome-aps.html

  Symptoms associated with APS vary depending on the how serious the conditions is, and where abnormal blood clots form. […] If a blood clot forms in the arms or legs, it may travel to the lungs (pulmonary embolism), brain (stroke) or heart (heart attack). General symptoms associated with abnormal blood clotting include: Chest pain, Shortness of breath, Repeated headaches, Changes in speech, Redness or swelling in the limbs, Tissue damage due to limited or blocked blood flow, Nausea. […] Women with APS who are pregnant may notice the following symptoms: Repeated miscarriages or stillbirths, Premature delivery, Preeclampsia. […] Patients who have experienced a stroke due to APS may display „classic” stroke symptoms including: Sudden numbness or weakness of the face, arm or leg, especially on one side of the body, Sudden confusion, Sudden trouble speaking, Sudden trouble seeing in one or both eyes, Sudden trouble walking, Sudden dizziness, loss of balance or coordination, Sudden, severe headache with no known cause.

• #4 Lupus anticoagulants and antiphospholipid antibodies Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/lupus-anticoagulants-and-antiphospholipid-antibodies

  Antiphospholipid syndrome (APS) is an autoimmune disorder that involves frequent blood clots (thromboses). When you have this condition, your body’s immune system makes abnormal proteins that attack the blood cells and lining of the blood vessels. The presence of these antibodies can cause problems with blood flow and lead to dangerous clots in blood vessels throughout the body. […] You may not have any symptoms, even though you have the antibodies. Symptoms that may occur include: Blood clots in the legs, arms or the lungs. The clots can be in either the veins or in the arteries. Recurrent miscarriages or still birth. Rash, in some people. […] In rare cases, clots suddenly develop in many arteries over a period of days. This is called catastrophic anti-phospholipid syndrome (CAPS). It can lead to stroke as well as the clots in the kidney, liver, and other organs throughout the body, and gangrene in the limbs. CAPS has a high mortality rate, even with treatment.

• #5 Antiphospholipid Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430980/

  Antiphospholipid syndrome is characterized by the presence of antiphospholipid antibodies in the setting of thrombosis or pregnancy loss or complications. […] The most common sites of venous and arterial thrombosis are the lower limbs and cerebral arterial circulation, respectively. However, thrombosis can occur in any organ. […] The hallmark of APS comprises the persistent presence of APLAs in the setting of arterial and venous thrombus or pregnancy loss. […] APS can lead to arterial or venous thrombosis involving any organ system. These clots can be isolated or recurrent and involve blood vessels not commonly associated with other causes of thrombosis, such as upper extremity thrombosis, Budd-Chiari syndrome, and sagittal sinus thrombosis. DVTs are the most common venous involvement and may lead to pulmonary embolism, resulting in pulmonary hypertension.

• #6 Antiphospholipid Syndrome: Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/21685-antiphospholipid-syndrome

  Antiphospholipid syndrome can cause blood clots throughout your body. […] Antiphospholipid syndrome makes you much more likely to develop blood clots. […] The blood clots from APS can cause severe, life-threatening complications like strokes. They can also make it more likely to experience miscarriages and other pregnancy complications. […] Some people with antiphospholipid syndrome notice mottled skin (livedo reticulitis) with a darkened, lace-like pattern. But most people with APS dont experience any noticeable symptoms until they have a blood clot or experience a pregnancy complication. […] Symptoms of a blood clot can include: Chest pain. Shortness of breath (dyspnea). Frequent headaches. Sudden pain in your arms, legs, back, neck or jaw. Redness or swelling in your arm or leg. Abdominal pain (a stomachache).

• #7 Antiphospholipid Syndrome Resources – Blood Clots

  https://www.stoptheclot.org/antiphospholipid-syndrome/

  Antiphospholipid Syndrome or APS is a syndrome in which your body recognizes phospholipids (part of a cells membrane) as foreign and produces antibodies against them including against the cells that line your blood vessels. If you have APS, you may be at a higher risk for blood clots and complications in pregnancy. […] If you have APS, you need to be aware of the symptoms of DVTs so you can seek medical attention. […] If you have a Deep Vein Thrombosis or DVT (leg or arm clot), you will notice: Pain or tenderness in your arm or leg often described as a cramp or Charley horse with one or more of the following: Swelling, Red or purple skin color, Warm to the touch. […] If you have a Pulmonary Embolism or PE (lung clot), you may experience: Difficulty breathing or shortness of breath, Chest pain especially when trying to breathe, Rapid or racing heart beat, Fainting or passing out, Coughing up blood.

• #8 Antiphospholipid Syndrome (APS) | Lupus Foundation of America

  https://www.lupus.org/resources/antiphospholipid-antibody-syndrome

  If you have blood clots, you may notice these symptoms in your arms or legs: Throbbing or cramping pain, Swelling, Redness, Heat. […] If a blood clot moves to your lungs, you may notice: Trouble breathing or shortness of breath, Sharp chest pain that gets worse when you breathe in, Coughing that brings up blood. […] If you have any of these symptoms, get medical help right away. Be sure to let the doctor know that you have APS.

• #9 Antiphospholipid Syndrome Symptoms, When to Get Medical Help

  https://www.healthline.com/health/antiphospholipid-syndrome-symptoms

  Symptoms of a heart attack include: chest pain, shortness of breath, pain in your arm, shoulder, or neck, nausea or vomiting. […] Symptoms of PE include the following: rapid, irregular heartbeat, shortness of breath, chest pain, clammy or bluish skin, coughing up blood. […] APS can cause complications during pregnancy, for example: repeated miscarriages, intrauterine growth restriction, which happens when a baby in the womb grows slower than expected, preeclampsia, or high blood pressure during pregnancy, eclampsia, a life threatening complication of preeclampsia. […] Symptoms are usually related to the presence of blood clots.

• #9 Antiphospholipid Syndrome Symptoms, When to Get Medical Help

  https://www.healthline.com/health/antiphospholipid-syndrome-symptoms

  Some people with APS develop a rash that looks like marble due to a pattern of differently colored skin patches. This condition is called livedo reticularis, or mottled skin. […] You can also develop skin sores, or ulcers, due to APS. In severe cases, lack of blood circulation can cause gangrene (dead tissue) in your limbs. […] If you bruise easily, see a field of tiny, pinprick sized blood spots on your skin (petechiae), or have prolonged bleeding episodes, you may have thrombocytopenia. […] Not everyone with AHA has symptoms, but you may have pale skin and feel excessively tired. […] Although less common, some people with APS have symptoms that usually happen in multiple sclerosis. These include: skin numbness and tingling, vision issues, for example, double vision, speech and memory problems, balance and walking difficulties.

• #10 Antiphospholipid syndrome – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/antiphospholipid-syndrome/symptoms-causes/syc-20355831

  Signs and symptoms of antiphospholipid syndrome can include: […] Blood clots can form in the legs, lungs and other organs, such as the kidneys and spleen. […] A stroke can occur in a young person who has antiphospholipid syndrome but no known risk factors for cardiovascular diseases. […] Less common signs and symptoms include: […] Chronic headaches, including migraines; dementia and seizures are possible when a blood clot blocks blood flow to parts of the brain. […] Antiphospholipid syndrome can damage heart valves. […] This decrease in blood cells needed for clotting can cause episodes of bleeding, particularly from the nose and gums. […] Complications of antiphospholipid syndrome can include: […] Decreased blood flow to a part of your brain can cause a stroke, which can result in permanent neurological damage, such as partial paralysis and loss of speech. […] A blood clot in your leg can damage the valves in the veins, which keep blood flowing to your heart. […] These can include miscarriages, stillbirths, premature delivery, slow fetal growth and dangerously high blood pressure during pregnancy (preeclampsia).

• #11 Antiphospholipid Syndrome

  https://www.brainfacts.org/diseases-and-disorders/neurological-disorders-az/diseases-a-to-z-from-ninds/antiphospholipid-syndrome

  Antiphospholipid syndrome (APS) is an autoimmune disorder caused when antibodies — immune system cells that fight off bacteria and viruses — mistakenly attack healthy body tissues and organs. […] The symptoms of APS are due to the abnormal blood clotting. Clots can develop in the veins of the legs and lungs, or in the placenta of pregnant women. One of the most serious complications of APS occurs when a clot forms in the brain and causes a stroke. Other neurological symptoms include chronic headaches, dementia (similar to the dementia of Alzheimers disease), and seizures. Infrequently, individuals will develop chorea (a movement disorder in which the body and limbs writhe uncontrollably), cognitive dysfunction (such as poor memory), transverse myelitis, depression or psychosis, optic neuropathy, or sudden hearing loss. In pregnant women, clots in the placenta can cause miscarriages.

• #12 APS: What Rheumatologists Should Know about Hughes Syndrome – The Rheumatologist

  https://www.the-rheumatologist.org/article/aps-what-rheumatologists-know-about-hughes-syndrome/?singlepage=1

  Possibly the commonest manifestation of APS is memory loss. Often, the problem only sees the light of day when the patient is asked about the symptom. So many patients confess to worries about Alzheimers. To date, detailed clinical studies are few and far between. From time to time, and, it must be said, in a fairly desultory fashion, we have carried out psychometric testing on selected APS patientsand the results have often been surprising. Even more so, given the striking improvement seen in memory tests when anticoagulation is commenced. […] Like migraine, stroke is one of the recognized complications of APS/Hughes syndrome. Figures as high as 1 in 5 young strokes (under 45) having positive aPL tests have been reported. […] In 1985, we observed that in lupus patients, seizures were more common in those patients with positive aPL tests. Since then, it has become clear that epilepsy, in all its forms, is an important accompaniment of APS.

• #13 Antiphospholipid syndrome (APS) | Symptoms, treatments

  https://versusarthritis.org/about-arthritis/conditions/antiphospholipid-syndrome/

  It is not unusual for people with APS to have periods of tiredness, forgetfulness, confusion and anxiety. […] Sometimes you may find it difficult to think of the words you want to say. In its extreme you may find dramatic gaps in your memory. You may forget how to do simple tasks, completely miss pre-planned events or even forget how to get home. […] Its important to get an early diagnosis and begin the right drug treatment as soon as possible to prevent future thromboses or miscarriages. It will also help you understand and get more help for the symptoms you are experiencing. […] Pregnant women with APS are at greater risk of miscarriage throughout their pregnancy. But the risk is particularly high during the second trimester, between three and six months. Women with APS are also five times more likely to have a stillbirth.

• #13 Antiphospholipid syndrome (APS) | Symptoms, treatments

  https://versusarthritis.org/about-arthritis/conditions/antiphospholipid-syndrome/

  APS is one of the most significant causes of repeated miscarriage, but once you have been diagnosed, treatment can reduce your risk in future pregnancies. […] APS can cause narrowing of the blood vessels, including those serving the kidneys, resulting in high blood pressure and poor kidney function. […] Testing for antiphospholipid antibodies is becoming routine in infertility clinics. […] People who have thrombosis or recurrent miscarriages should be routinely tested for APS. […] Its one of the most common causes of strokes in young people. Its estimated that one in six people who have had a stroke before the age of 40 may have APS. […] The tests for APS are: the anticardiolipin test, the lupus anticoagulant test, the anti-beta-2-glycoprotein 1 test. […] If you have other factors that increase your risk, such as a family history of clots, or if you suffer from typical APS symptoms, such as migraines, your specialist may recommend that you take warfarin instead of aspirin.

• #14 Antiphospholipid syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Antiphospholipid_syndrome

  Antiphospholipid syndrome, or antiphospholipid antibody syndrome (APS), is an autoimmune, hypercoagulable state caused by antiphospholipid antibodies. APS can lead to blood clots (thrombosis) in both arteries and veins, pregnancy-related complications, and other symptoms like low platelets, kidney disease, heart disease, and rash. […] Antiphospholipid syndrome is known for causing arterial or venous blood clots, in any organ system, and pregnancy-related complications. While blood clots and pregnancy complications are the most common and diagnostic symptoms associated with APS, other organs and body parts may be affected like platelet levels, heart, kidneys, brain, and skin. […] In pregnant people affected by APS, there is an increased risk of recurrent miscarriage, preterm birth, intrauterine growth restriction, pre-eclampsia, eclampsia.

• #14 Antiphospholipid syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Antiphospholipid_syndrome

  Other common findings that suggest APS are low platelet count, heart valve disease, high blood pressure in the lungs, kidney disease, and a rash called livedo reticularis. […] Factors that increase likelihood of developing APS related future blood clots and pregnancy complications include: presence of all three antibodies (2 glycoprotein 1, lupus anticoagulant, and anticardiolipin), moderate to high levels of an APS antibody, presence of IgG APS antibodies. […] Also, a history of previous blood clots in someone with APS increases the risk for certain pregnancy complications, such as death of the child, smaller sized baby, and blood clots during and after pregnancy.

• #15 Antiphospholipid Syndrome – ERN ReCONNET | European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases

  https://reconnet.ern-net.eu/disease-aps/

  Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by arterial, venous, or small vessel thromboembolic events and/or obstetric morbidity in the presence of persistent circulating antiphospholipid (aPL) antibodies detected by means of three tests: lupus anticoagulant, anticardiolipin, and beta-2 glycoprotein I antibodies. […] Common symptoms include thrombosis (blood clot) such as deep venous thrombosis, transient ischemic attack (TIA), stroke, and heart attack. […] In addition to thrombotic events, obstetric complications are the other hallmark of APS, including embryonic losses, fetal loss, and premature births due to severe preeclampsia or placental insufficiency. […] Rarely, a life-threatening form of multiorgan thrombosis, known as catastrophic APS (CAPS), can occur.

• #16 Antiphospholipid Syndrome (APS) – LEVY Health

  https://levy.health/antiphospholipid-syndrome-aps/

  Antiphospholipid syndrome (APS), also known as Hughes syndrome, is an autoimmune disease that increases someones risk for developing blood clots. […] The main symptom of antiphospholipid syndrome is blood clots. When a blood clot blocks a vein, its known as thrombosis. Thromboses happen most often in the legs. […] APS is the most common, treatable cause of recurrent miscarriage (15% are due to APS), but it can also cause other types of complications during pregnancy. Antiphospholipid antibodies lead to early pregnancy loss because they stop the embryo from properly implanting in the uterus and stop fetal cell growth. The majority of miscarriages in women with APS happen in the first 13 weeks of pregnancy. […] Late pregnancy loss is also common in women with APS, with miscarriage occuring between three and six months. Antibodies cause clots in the small veins of the placenta. This prevents the placenta from supplying the baby with the nutrients and oxygen necessary to grow.

• #17 Patient education: Antiphospholipid syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/antiphospholipid-syndrome-beyond-the-basics

  Thrombocytopenia — In some people, APS leads to a decrease in the number of blood cells called platelets. This condition is known as thrombocytopenia. […] Platelets are essential to the normal blood clotting process. When the number of platelets is significantly lowered (to less than 30,000), there is a risk of bleeding, particularly from the nose and gums, into the skin (called petechiae), from the digestive tract, and from the uterus in females. However, in people with APS, the reduced number of platelets may be associated with an increased risk of blood clots rather than bleeding problems.

• #18 Antiphospholipid Syndrome: Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/21685-antiphospholipid-syndrome

  APS symptoms you might not be able to see, feel or notice can include having: Low blood platelet levels. Anemia. Heart valve abnormalities. […] Antiphospholipid syndrome can cause severe, potentially fatal complications. […] The most severe APS complications happen when blood clots block blood vessels throughout your body, including in your: Brain (strokes). Heart (thrombosis). Lungs (pulmonary embolism). Kidneys. […] If youre pregnant, APS may cause a miscarriage if a clot blocks the flow of nutrients in your placenta. It can also increase your risk of preeclampsia. […] APS doesnt usually go away. You may never have a clot or experience complications, but youll probably need to take blood thinners for the rest of your life. […] The most important part of living with APS is preventing blood clots. Taking blood-thinning medication is a big part of that prevention. […] Antiphospholipid syndrome can increase the risk of pregnancy-related complications.

• #19 Antiphospholipid Syndrome (APS): Symptoms and Treatment

  https://patient.info/allergies-blood-immune/blood-clotting-tests/antiphospholipid-syndrome

  A blood clot in an artery can lead to diseases such as a stroke, transient ischaemic attack (TIA) and high blood pressure (hypertension). About 13 in 100 people with APS first present with a stroke and, in 7 out of 100 people, the first sign of APS is a TIA. […] Tiny blood clots in the blood vessels within the placenta can lead to complications in pregnancy. This is called obstetric APS. The most common problem is recurrent miscarriage. This is three or more consecutive miscarriages. […] Symptoms can occur in virtually any organ of the body. […] A blood clot can occur in a blood vessel within a kidney. This can affect the kidney function and may lead to chronic kidney disease (CKD). […] This includes problems with the valves in the heart which can also increase the risk of stroke. An inflammation of the lining of the heart (endocarditis) can occur because of blood clots forming on the heart valves. A heart attack (myocardial infarction, or MI) due to a blood clot in one of the blood vessels that supply the heart muscle itself (the coronary arteries) can occur in APS.

• #19 Antiphospholipid Syndrome (APS): Symptoms and Treatment

  https://patient.info/allergies-blood-immune/blood-clotting-tests/antiphospholipid-syndrome

  As well as stroke and TIA, APS is associated with other problems in the brain. These include migraine, seizures, memory loss and abnormal movement disorders. […] A lace-like, purple mottled rash called livedo reticularis can occur – usually on the legs. […] Antiphospholipid antibodies are associated with infertility. Testing for them is becoming more routine in investigations to find the cause of infertility. […] This is a rare but very severe form of APS. About half of people who have it may die. This is because widespread blood clots affect the oxygen supply to the body’s main organs. These start to shut down, which is called organ failure. […] The severity of APS varies from person to person so the outlook (prognosis) is also variable. APS can cause life-threatening or life-limiting illness – depending on whether a blood clot causes a serious problem in your body. […] Long-term anticoagulation does seem to improve prognosis in APS. With the appropriate medication and a healthy lifestyle, most people with primary APS can lead a normal healthy life.

• #20 Antiphospholipid Syndrome: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1006128-overview

  Antiphospholipid syndrome (APS) is an acquired autoimmune disorder that manifests clinically as recurrent venous or arterial thrombosis and/or fetal loss. […] Clinically, the series of events that leads to hypercoagulability and recurrent thrombosis can affect virtually any organ system, including the following: Peripheral venous system (deep venous thrombosis [DVT]), Peripheral nervous system (peripheral neuropathy, including GuillainBarr syndrome), Hematologic (thrombocytopenia, hemolytic anemia), Obstetric (pregnancy loss, eclampsia), Pulmonary (pulmonary embolism [PE], pulmonary hypertension), Dermatologic (livedo reticularis, purpura, infarcts/ulceration), Cardiac (Libman-Sacks valvulopathy, MI, diastolic dysfunction), Ocular (amaurosis, retinal thrombosis), Adrenal (infarction/hemorrhage), Musculoskeletal (avascular necrosis of bone), Renal (thrombotic microangiopathy). […] Late spontaneous fetal loss (second or third trimester) is common; however, it can occur at any time during pregnancy. Recurrent early fetal loss (10 weeks gestation) is also possible.

• #21 Antiphospholipid antibody syndrome Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/antiphospholipid-antibody-syndrome.html

  The symptoms of APS can include any of the following: […] APS can cause: […] heart attacks (up to 20% of younger people who have a heart attack have antiphospholipid antibodies) […] APS can affect the blood supply to the intestines, causing abdominal pain, fever, and blood in the stool. […] APS can cause a condition called Budd-Chiari syndrome. In this syndrome, a blood clot prevents blood from flowing out of the liver. The person may experience nausea, vomiting, jaundice (yellow skin), dark urine, pale stool, and swelling of the abdomen. […] Blood clots that affect the kidneys can cause kidney damage and blood in the urine. […] APS can cause purple and white mottling of the skin, repeated sores (ulcers), repeated bumps (nodules), and tissue in the fingertips to die (gangrene).

• #21 Antiphospholipid antibody syndrome Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/antiphospholipid-antibody-syndrome.html

  Veins or arteries in the retina can be affected. This can cause blurring or loss of vision. […] APS can cause problems for the pregnant woman such as stroke or blood clots in the lungs. […] Some people with APS continue to have symptoms off and on throughout their lives. Others improve without any repeat episodes. […] Some people even lose the antibodies associated with the syndrome. This can happen with primary APS. But it is especially common after a viral infection, in women who recently were pregnant, or when a medication suspected to be associated with APS is no longer used. […] People with primary APS generally lead normal, healthy lives with the help of medication and lifestyle changes. […] Some people with APS will have repeated blood clots despite the best treatments. This is referred to as catastrophic antiphospholipid antibody syndrome, a condition that, as the name suggests, can be fatal.

• #22 Catastrophic Antiphospholipid Syndrome | HSS Rheumatology

  https://www.hss.edu/conditions_catastrophic-antiphospholipid-syndrome.asp

  Antiphospholipid syndrome (APS) is a systemic autoimmune disorder in which the patients immune system makes antibodies (antiphospholipid antibodies [aPL]) that increase the risk of blood clots (thickened blood) and pregnancy complications. […] Catastrophic APS, sometimes referred to as CAPS, is the most severe form of APS and is very rare. In CAPS, multiple blood clots in small (also referred as microvascular disease or microvascular APS), medium, and/or large blood vessels occur over a short period (usually within a week), sometimes associated with thrombocytopenia, hemolytic anemia, and/or thrombotic microangiopathy. […] Individuals who develop CAPS will typically manifest multiple blood clots with or without microvascular disease and/or a systemic thrombotic microangiopathy (TMA). Multiple blood clots can result in infarction (lack of oxygen in tissues) and failure of different organs, leading to multiple organ dysfunction a life-threatening condition requiring intensive care unit (ICU) management.

• #22 Catastrophic Antiphospholipid Syndrome | HSS Rheumatology

  https://www.hss.edu/conditions_catastrophic-antiphospholipid-syndrome.asp

  Catastrophic APS is a serious condition, and the diagnosis requires careful evaluation. If your doctor suspects CAPS, they will likely start treatment even before confirming the diagnosis to prevent life-threatening complications. […] Analysis of the published catastrophic APS case reports shows that mortality from this condition has been decreasing since the year 2000. This is probably due to the increased recognition and early treatment of the disease. However, catastrophic APS remains a very serious life-threatening condition. […] Based on one retrospective (looking back at collected data) study that analyzed long-term outcomes (up to six years) in catastrophic APS patients, approximately 70% of the patients who survived the initial catastrophic APS event and took warfarin (a blood thinner), remained free of blood clots. CAPS can cause serious complications, leading to long-term disability. It progresses quickly, often damaging organs like the kidneys, brain, and lungs. Many survivors develop chronic kidney disease, cognitive problems, motor issues, or pulmonary hypertension due to blood clots and organ damage. Immediate medical treatment is essential to limit these effects. […] Following a catastrophic APS event, permanent damage may occur; the extent of this damage depends on the type and severity of the organs involved. After an acute event, catastrophic APS patients receive long term anticoagulation therapy.

• #23 Antiphospholipid Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430980/

  Pregnancy loss is common in patients with APS, especially in the second or third trimester. […] Catastrophic antiphospholipid syndrome (CAPS) is a rare but life-threatening complication of APS, with fewer than 1% of patients with APS developing CAPS. Mortality rates are high (48%), especially in patients with SLE or those with cardiac, pulmonary, renal, and splenic involvement. […] The clinical features vary significantly and can be as mild as asymptomatic APLA positivity or as severe as catastrophic APS. Arterial and venous thrombosis and pregnancy-related complications are the hallmarks of the disease. […] The occurrence of arterial thrombosis carries a poor prognostic value, given the high risk of recurrence in these cases. […] Poor prognostic features include CAPS, pulmonary hypertension, nephropathy, central nervous system (CNS) involvement, and gangrene of the extremities.

• #24 Antiphospholipid syndrome: Symptoms, treatment, and diagnosis

  https://www.medicalnewstoday.com/articles/181700

  Antiphospholipid syndrome is an immune disorder in which abnormal antibodies are linked to abnormal blood clots in veins and arteries. It may lead to complications in pregnancy, such as recurring pregnancy loss and preterm births. Signs and symptoms of antiphospholipid syndrome depend mainly on where the clots travel to, and where they form. A clot or embolus, which is a traveling clot, can result in: DVT: A clot forms in one of the large veins, usually in the arm or leg, and it partially or completely blocks circulation. If a DVT blood clot moves into the lungs, a life-threatening condition known as a pulmonary embolism (PE) can result. Pulmonary embolism (PE): An embolus, or traveling clot, appears in one part of the body, circulates throughout the body, and then blocks blood flowing through a vessel in another part of the body. In PE, an embolus blocks an artery that feeds the lungs. Complications of pregnancy: These include recurring miscarriages, preterm delivery, and preeclampsia, or high blood pressure during pregnancy. Ischemic stroke: A blood clot interrupts blood flow to a part of the brain, cutting off the supply of oxygen and glucose. Brain cell death and brain damage can result. Symptoms tend to appear between the ages of 20 and 50 years, but sometimes they develop during childhood. Catastrophic antiphospholipid syndrome (CAPS) is a type of thrombotic storm, in which multiple clots suddenly form. Symptoms vary, depending on which organs are affected, but they include: abdominal pain, confusion, edema, or swelling, in the ankles, feet, or hands, fits, or seizures, progressive breathlessness, tiredness, coma, death. Symptoms tend to appear suddenly and get worse rapidly.

• #25 Movement Disorders in Antiphospholipid Syndrome & Systemic Lupus Erythematosus

  https://practicalneurology.com/articles/2020-sept/movement-disorders-in-antiphospholipid-syndrome-systemic-lupus-erythematosus

  Chorea. The most common movement disorder in APS is chorea, with a prevalence estimated at 1% to 4%. Chorea may be the presenting symptom of APS. In the largest review to date of chorea in APS, clinical manifestations, neurologic characteristics, and immunologic findings in 50 participants with APS and chorea were characterized. Of those included, 96% were female, and the mean age of onset of chorea was 21 years (range 6-77 years). Notably, 70% (n=35) also met criteria for SLE or SLE-like syndrome; 30% (n=15) had primary APS. The majority (66%, n=33) had only 1 episode of chorea; the rest had between 2 and 6 reported episodes. In 55% of those in whom laterality of chorea was reported (n=38), it was bilateral; in 4 others, chorea began unilaterally and reappeared later on the contralateral side. Interestingly, 6 patients developed chorea soon after starting on OCPs, 3 developed chorea during pregnancy, and 1 developed it shortly after delivery. Immunologic testing revealed lupus anticoagulant (LA) in 92% and anticardiolipin antibodies (aCL) in 91% (-2-glycoprotein [2GP] antibody levels were not reported). Neuroimaging was normal in the majority of cases (65%, n=31). Various treatments were tried, including combinations of steroids, haloperidol, aspirin, anticoagulants, and immunosuppressive agents, based on the combined clinical characteristics. All but 1 person recovered, suggesting that regardless of treatment, the prognosis is generally good.

• #26 Movement Disorders in Antiphospholipid Syndrome & Systemic Lupus Erythematosus

  https://practicalneurology.com/articles/2020-sept/movement-disorders-in-antiphospholipid-syndrome-systemic-lupus-erythematosus

  Ataxia. Both subacute and chronic ataxia have been described in the context of APS, often associated with other neurologic symptoms including parkinsonism, chorea, dystonia, tremors, cognitive decline, dysarthria, and optic neuropathy. An underlying malignancy was found in many of these cases, often several years after the initial presentation. There were no consistently reported imaging abnormalities. Multiple treatments have been tried, including plasmapheresis, prednisone, hydroxychloroquine, warfarin, aspirin, levodopa, and piracetam. In a series of 10 cases, all individuals who presented with subacute onset of ataxia (n=4) recovered, regardless of treatment. All who presented with chronic ataxia (n=6), in contrast, ultimately died of myocardial infarction (n=2), sepsis, or multiorgan failure with sepsis in the context of a cancer diagnosis (n=4).

• #27 Movement Disorders in Antiphospholipid Syndrome & Systemic Lupus Erythematosus

  https://practicalneurology.com/articles/2020-sept/movement-disorders-in-antiphospholipid-syndrome-systemic-lupus-erythematosus

  Other Hyperkinetic Movement Disorders. Other hyperkinetic movement disorders have been reported in association with APS. A case series reported 3 children with hemidystonia and elevated aCL associated with MRI T2 hyperintensities in the contralateral internal capsule, caudate, and putamen. In another case report, a person presented with paroxysmal choreiform movements of the right upper and lower extremities, consistent with paroxysmal nonkinesigenic dyskinesia. This person had T2 hyperintensities in the medial right frontal lobe and basal ganglia on MRI, LA, and elevated aCL. Symptoms resolved within several weeks after she was started on anticoagulants and advised to stop smoking and discontinue OCPs. A series of 2 cases of hyperkinetic movement disorders associated with APS includes a person who presented with tics associated with dysarthria and psychiatric symptoms, elevated aCL IgG, and a positive dilute Russell viper venom test (DRVVT)a test for LA. Brain MRI showed T2 hyperintensities in the centrum semiovale and right occipital lobe. The second person presented with an action tremor, myoclonus, and dyskinetic movements of the tongue. Laboratory findings included elevated aCL, antinuclear antibodies (ANA), and positive DRVVT. Brain MRI showed T2 hyperintense lesions in the bilateral subcortical white matter and small bilateral cerebellar infarcts. This individual had significant improvement after starting treatment with warfarin. Finally, there is a case report of a person with an acute onset complex hyperkinetic syndrome consisting of chorea, left foot dystonia, oral dyskinesias, and speech impairment associated with multiple subcortical lesions and a large ischemic-appearing lesion in the left posterior temporal lobe. The individual had elevated aCL and 2GP and positive findings for LA. Movement disorder symptoms improved after treatment with warfarin and prednisone.

• #28 Movement Disorders in Antiphospholipid Syndrome & Systemic Lupus Erythematosus

  https://practicalneurology.com/articles/2020-sept/movement-disorders-in-antiphospholipid-syndrome-systemic-lupus-erythematosus

  Hypokinetic Movement Disorders. There are 8 cases associated with parkinsonism reported to date, 7 of which were associated with ischemic-appearing changes on MRI. Of these, 5 individuals had associated cognitive dysfunction, and 2 had other movement disorders (dystonia and ataxia). Only 1 person improved with levodopa treatment, and notably, his parkinsonism occurred in the context of transient basal ganglia hyperintensities after pulmonary endarterectomy under total cardiopulmonary bypass for chronic thromboembolic pulmonary hypertension attributed to his history of APS.

• #29 Lupus anticoagulants and antiphospholipid antibodies Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/lupus-anticoagulants-and-antiphospholipid-antibodies

  Without treatment, people with APS will have repeat clotting events. Most of the time, outcome is good with proper treatment, which includes long-term anticoagulation therapy. Some people may have blood clots that are hard to control in spite of treatments. This can lead to CAPS, which can be life-threatening.

• #30 Antiphospholipid Syndrome (APS) Causes, Symptoms, Treatment, Medications, Prevention

  https://www.medicinenet.com/antiphospholipid_syndrome/article.htm

  Antiphospholipid syndrome is a disorder of the immune system that is characterized by excessive clotting of blood and/or certain complications of pregnancy (premature miscarriages, unexplained fetal death, or premature birth) and the presence of antiphospholipid antibodies (such as anti-cardiolipin or lupus anticoagulant antibodies) in the blood. […] Clotting disorders associated with antiphospholipid syndrome include stroke, blood clots deep within the legs (deep venous thrombosis, or DVT) and clots in the lungs (pulmonary embolism, or PE). Patients with antiphospholipid syndrome have both blood clots and antiphospholipid antibodies that are detectable with blood testing. […] The prognosis of antiphospholipid syndrome depends on the character and the intensity of its manifestations. Earlier treatment will tend to have better outcomes.

• #31 Antiphospholipid Syndrome (APS Syndrome): Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/antiphospholipid-syndrome/guide/

  Antiphospholipid syndrome can cause blood clots, which can lead to stroke and other heart problems, as well as pregnancy complications such as miscarriage and stillbirth. […] With treatment and healthy lifestyle habits, people with antiphospholipid syndrome can expect to live generally healthy lives. Some studies have shown that antiphospholipid syndrome is associated with up to a 94 percent survival rate after 10 years. The condition can cause permanent health problems, however: Research has found that more than 30 percent of people with the condition experience organ damage and more than 20 percent have serious complications that include pulmonary hypertension (high blood pressure in the lungs) and impaired kidney function after 10 years.

• #32 Antiphospholipid Syndrome: Symptoms, Diagnosis and Treatments

  https://www.webmd.com/dvt/what-is-antiphospholipid-syndrome

  Pregnancy complications linked to APS include: A hard time getting pregnant, Preeclampsia (high blood pressure), Miscarriage, usually after the 10th week of pregnancy, Premature birth, usually before the 34th week of pregnancy, Babies born small or underweight. […] Treatment for APS can reduce your risk for these complications. […] If you think you’re having symptoms of a blood clot, get medical help immediately. Clots can be dangerous and even deadly.

• #33

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut3224

  Antiphospholipid syndrome (APS) is a condition that makes the blood clot too easily. This can lead to serious problems, such as a stroke, a heart attack, and blood clots in the legs or lungs. During pregnancy, APS can lead to miscarriage and other serious pregnancy problems. […] You have symptoms of a stroke. These may include: Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body. Sudden vision changes. Sudden trouble speaking. Sudden confusion or trouble understanding simple statements. Sudden problems with walking or balance. A sudden, severe headache that is different from past headaches. […] You have signs of a blood clot in your leg (called a deep vein thrombosis), such as: Pain in your calf, back of the knee, thigh, or groin. Redness and swelling in your leg or groin.

• #34

• #35 Antiphospholipid Syndrome: Symptoms, Treatment, and More

  https://www.healthline.com/health/hughes-syndrome

  The symptoms of APS can be hard to spot. Thats because blood clots arent something you can easily identify without other health conditions or complications. […] APS sometimes causes a lacy red rash or bleeding from your nose and gums. Other signs that you may have blood clotting issues include: chest pain, shortness of breath, nausea, fatigue, pain or discomfort in the arms or legs, back, neck, or jaw, speech changes, chronic headache, memory loss, vision changes, balance or mobility issues. […] Left untreated, APS can damage your cardiovascular system and increase your risk for other health conditions, like miscarriage and stroke. For most people with APS, signs, symptoms, and related health risks can be managed with blood thinners and anticoagulant medications. […] There are some cases where these treatments arent effective, and other methods need to be used to keep your blood from clotting. Treatment of APS is lifelong, as theres no cure for this condition.

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