Alex Ehsan: Antiphospholipid Syndrome – A Practical Guide
Alex Ehsan, Hematologist and Medical Oncologist at Starling Oncology, shared a post on X:
”Antiphospholipid Syndrome (APS)
APS is an autoimmune clotting disorder that can cause DVT, PE, stroke, cerebral venous sinus thrombosis, arterial thrombosis and pregnancy complications.
Test the complete APS panel
- Lupus anticoagulant with dRVVT and confirmatory testing
- Anticardiolipin IgG and IgM
- β2 glycoprotein I IgG and IgM
A positive result should be confirmed at least 12 weeks later to establish persistence.
Anticoagulants can interfere particularly with lupus anticoagulant testing.
For confirmed thrombotic APS, warfarin is generally preferred, usually INR 2 to 3 for venous thrombosis.
Warfarin is particularly important with triple positive APS, arterial thrombosis or recurrent thrombosis.
DOACs should generally be avoided in triple positive or arterial APS.
They may be considered selectively in lower risk venous APS when warfarin cannot reasonably be used.
A positive antibody alone does not equal APS.
The clinical thrombotic history plus persistent antibody profile determine the diagnosis and treatment.
Educational only.”
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