Diagnostics and treatment of thrombotic antiphospholipid syndrome (APS): A personal perspective

Thrombosis Research
Vittorio Pengo, Gentian Denas

Abstract

Antiphospholipid Syndrome (APS) is a condition characterized by the occurrence of thromboembolic events and/or pregnancy loss combined with one laboratory criterion among Lupus Anticoagulant- LAC, anticardiolipin -aCL, and anti β2-Glycoprotein I -aβ2GPI antibodies. Several hypotheses were put forward to explain the causal role of antibodies in the clinical events but none is fully convincing. Current laboratory diagnosis is based on three tests (LAC, IgG/IgM aβ2GPI and IgG/IgM aCL antibodies). The triple-positive profile (all the three tests positive, same isotype) is associated with a higher risk for thrombosis. The mainstay of therapy in thrombotic APS is anticoagulation, with VKAs being the cornerstone. Low dose aspirin in combination or alone may have a role in arterial thrombosis, and in primary thromboprophylaxis. The Non-Vitamin K Antagonists Oral Anticoagulants (NOACs) role in the therapy of APS is under investigation but not verified. Alternative treatment options including rituximab and eculizumab have been successfully reported in few cases of catastrophic APS.

Citations

Oct 18, 2019·VASA. Zeitschrift für Gefässkrankheiten·Rupert BauersachsEdelgard Lindhoff-Last
Jul 4, 2020·Journal of Thrombosis and Haemostasis : JTH·Katrien M J DevreeseHarlinde Peperstraete
May 16, 2019·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Brian NguyenJason A Ferreira
Jan 3, 2021·Journal of Thrombosis and Thrombolysis·Sevinc Sarinc UlasliSule Apras Bilgen
Dec 19, 2020·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Stavros K KakkosMelina Vega de Ceniga
May 12, 2021·Journal of Thrombosis and Thrombolysis·Vittorio PavoniAndrew Horton
May 23, 2021·Thrombosis Research·Romy M W de Laat-KremersBas de Laat
Jul 11, 2020·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Laura HeiremanKatrien Devreese

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