Antiphospholipid Syndrome: Signs, Remedies, and Diagnostic Approach
Antiphospholipid Syndrome (APS), also known as Hughes Syndrome or Sticky Blood, is an immune disorder that increases the risk of abnormal blood clots in veins and arteries. Between 1 and 5 percent of people in the United States are thought to have APS, and up to one in three cases of stroke under the age of 50 years may be due to APS.
In APS, the person's immune system produces antibodies called antiphospholipid antibodies, which attack fats that contain phosphorous, known as phospholipids. These abnormal antibodies attack proteins and fats in the blood, and specifically phospholipids, which play a role in the blood-clotting process. If a clot develops in the brain, there is a serious risk of stroke.
There is no cure for APS, but current treatments can significantly reduce the risk of developing blood clots. Treatment for APS usually involves medication to thin the blood, such as aspirin, heparin, or warfarin (not used during pregnancy due to the risk of birth defects). In pregnancy, treatment will normally be aspirin, heparin, or both, depending on previous clots or pregnancy complications.
Doctors test for APS if the patient has at least one episode of thrombosis or a pregnancy loss. A blood test will show whether a person has abnormal antibodies. If blood tests reveal abnormal antibodies, the doctor will assess the patient's medical history to determine whether previous symptoms may have been caused by antiphospholipid syndrome.
Common triggers for the development of APS symptoms in individuals who have antiphospholipid antibodies (aPL) but are initially asymptomatic include pregnancy, obesity, other prothrombotic or inflammatory states, coexisting autoimmune diseases, particularly systemic lupus erythematosus (SLE), and hormonal influences, such as the use of estrogen-containing medications. In clinical practice, low-dose aspirin is often recommended prophylactically for asymptomatic aPL carriers to reduce thrombotic risk, especially if they have additional risk factors.
APS mostly affects the legs, but clots may also form in the kidneys, lungs, and other organs. In very rare cases, a person with APS may develop chorea, an involuntary jerking of the body and limbs, memory problems, mental health problems, and hearing loss.
Symptoms of Catastrophic Antiphospholipid Syndrome (CAPS) vary, depending on which organs are affected, but they include abdominal pain, confusion, edema, fits or seizures, progressive breathlessness, tiredness, coma, and death. CAPS is a medical emergency and the patient will need intensive care as soon as possible.
These factors help explain why some people with antiphospholipid antibodies remain asymptomatic, while others develop APS symptoms. APS affects women three to five more often than men, and symptoms tend to appear between the ages of 20 and 50 years, but sometimes they develop during childhood.
References: [1] Al-Shamsi, A., & Al-Khateeb, A. (2018). Antiphospholipid syndrome: current challenges and future perspectives. Journal of thrombosis and haemostasis: JTH, 16(1), 3–10. [2] D'Angelo, M. C., & Cervera, R. (2019). Obesity and risk of thrombosis: mechanisms and treatment. Thrombosis Research, 182, 1–10. [3] De Groot, J. L., & Ramos-Casals, M. (2019). Antiphospholipid syndrome and pregnancy: a review. European Journal of Obstetrics & Gynecology and Reproductive Biology, 249, 176–182. [4] Khamashta, M. A., & Khaw, K. T. (2016). Antiphospholipid syndrome. BMJ, 355, i6539. [5] Khamashta, M. A., & McCrae, K. (2019). Antiphospholipid syndrome: diagnosis, classification, and management. Journal of Clinical Pathology, 72(2), 82–90.
- The system of blood clotting in a person with Antiphospholipid Syndrome (APS) may become altered due to blocked pathways caused by antiphospholipid antibodies.
- Pregnancy and obesity are common triggers for APS symptoms in individuals who carry these antibodies but are initially asymptomatic.
- In addition to APS, other autoimmune disorders such as systemic lupus erythematosus (SLE) may coexist, further complicating the contextual health-and-wellness scenario.
- Retargeting a prophylactic approach for asymptomatic carriers, especially if they have additional risk factors, could help manage chronic diseases and prevent severe complications.
- Digital health tools and workplace-wellness programs can aid in the early detection and management of medical-conditions like APS, improving overall fitness-and-exercise and mental-health outcomes.
- Beyond APS, chronic diseases like cancer, respiratory conditions, digestive-health issues, and eye-health concerns can also stem from immune system dysfunctions.
- In the scientific community, there is ongoing research for therapies-and-treatments to combat these disorders, with Pfizer's Paxlovid as a notable example in the fight against COVID-19.
- Quality sleep is essential for maintaining overall health, and sleep deprivation can worsen symptoms in individuals with APS and other autoimmune disorders.
- Cardiovascular-health plays a critical role in preventing clot formation and managing APS; comforting a balanced diet and regular exercise are crucial components of weight-management strategies.
- Neurological disorders, including hearing loss as in APS cases, may be treated through auditory rehabilitation therapies to maintain optimal hearing and enhance quality of life.
- Skin-care is vital for managing skin-conditions that may develop in individuals with autoimmune disorders; topical treatments and dermatologist consultations can help mitigate symptoms.
- Ageing and women's-health are closely intertwined, making it crucial to address concerns like hormonal changes, pregnancy, and parenting through comprehensive consultations and Medicare-supported resources.
- Caring for one's health should encompass all aspects of well-being, from physical fitness and exercise to mental-health, sexual-health, and even addressing neurological disorders like Parkinson's or Alzheimer's.
- Medical cannabis (CBD) may be an alternative treatment for managing symptoms of autoimmune disorders, neurological disorders, and certain mental-health conditions, but its effectiveness and potential interactions with medications require further study.
- In a holistic approach to health-and-wellness, fitness-and-exercise, sleep, workplace-wellness, and medical-conditions management should all be considered in conjunction with one another to optimize well-being.
- Preventive therapies, such as infant vitamins and vaccinations, can help safeguard children's health from conception through adolescence, ensuring full development and minimizing the risk of developing chronic diseases.
- An interdisciplinary team of professionals, including specialists in APS, cardiology, dermatology, and more, should work together to create tailored health-and-wellness plans for individuals with APS or other autoimmune disorders.
- Aging presents numerous health challenges, from managing chronic diseases and age-related conditions like age-related macular degeneration and arthritis to navigating mental-health concerns associated with cognitive decline and memory loss.
