clinical features

Last reviewed 01/2018

Due to the diversity of the condition antiphospholipid syndrome (APS) may affect all organ systems of the body.

The clinical features are presented according to the systems affected:

  • thrombosis
    • venous thrombosis and associated complications
      • is more common than arterial thrombosis
      • in a cohort of 1000 patients, 32% presented with deep vein thrombosis in the leg as the initial symptom while in 14%, pulmonary embolism was the first symptom
      • renal, hepatic, subclavian and retinal veins; cerebral sinuses and vena cava are also at a higher risk for thrombotic events when compared to thrombosis not related antiphospholipid syndrome
    • arterial thrombosis
      • most common initial clinical manifestations are stroke (in 13%) and transient ischemic attack (in 7%)
    • recurrent thrombosis
  • cerebral involvement
    • is common and include - cerebral ischemia, migraine, cognitive dysfunction, seizures, chorea, psychosis, depression, Guillain-Barre syndrome
    • a link between valvular heart disease and CNS manifestations of the syndrome has been reported 
  • cardiac manifestations
    • non bacterial thrombotic endocarditis
    • myocardial infarction
  • renal manifestations
    • due to thrombosis of the renal vasculature, rapid decline of the renal function can occur
  • haematological manifestation
    • thrombocytopaenia
    • haemolytic anaemia
    • dermal symptoms e.g. - lividoreticularis
  • maternal and fetal effects
    • recurrent early miscarriages
    • intrauterine fetal death
    • early or severe pre-eclampsia (or both)
    • intrauterine growth restriction (1)
  • endocrine
  • dermatological

Reference: