General Internal Medicine

Antiphospholipid Syndrome

Questions discussed in this category

Would you consider using DOACs as a bridge to warfarin instead of heparin or LMWH?

For example, would you consider this method in an ESRD/HD patient with antiphospholipid syndrome who had a major bleed requiring reversal of warfarin ...

4 Answers available

Can anti-cardiolipin or anti-beta-2 glycoprotein antibodies cause prolonged PTT in the absence of a lupus anticoagulant?

Labs with normal PT, but prolonged PTT (47 sec, ULN 40 sec) that does not correct on immediate mix. Lupus anticoagulant negative (DRVVT and hexagonal ...

1 Answer available

How would you approach pursuing a kidney biopsy in a patient with suspected lupus nephritis who is on warfarin for antiphospholipid antibody syndrome?

2 Answers available

What is your approach to diagnosis and evaluation of nonbacterial thrombotic endocarditis (Libman-Sacks)?

Patient with negative blood cultures, completed 6 weeks of IV antibiotics and vegetation persists. CT imaging without evidence of malignancy. No evide...

3 Answers available

Do you typically screen patients for antiphospholipid antibodies in autoimmune diseases besides lupus in the absence of a clotting event?

6 Answers available

Does phosphatidylserine antibody play a role in the diagnosis of antiphospholipid antibody syndrome?

3 Answers available

Do you avoid ESA use in patients with anemia and chronic kidney disease who also have APLS and risk for thrombosis?

2 Answers available

How would approach the management of a patient with significantly positive anticardiolopin and beta 2 glycoprotein antibodies in the absence of any clotting (including obstetric) history but with significant thrombocytopenia (but no other features of active connective tissue disease)?

1 Answer available

How do you manage a DOAC if interested in testing for lupus anticoagulant?

Significant history of autoimmune diseases and DVT in family, recent PE/DVT for a month

4 Answers available

How would you manage warfarin in a patient with APLS and alcoholic cirrhosis?

Nonreliable INR, given hepatic coagulopathy

1 Answer available

In antiphospholipid syndrome with recurrent strokes, would you consider adding antiplatelets to warfarin?

Also how would you manage this perioperatively?

7 Answers available

Do the level of positive lupus anticoagulant titers correlate with the risk of VTE?

1 Answer available

Is there a role for hydroxychloroquine for secondary prevention in patients with APS without SLE?

1 Answer available

How do you approach low to moderate titer of APLS when working up unprovoked DVT if it is persistent on repeat testing?

4 Answers available

How do you manage a patient with progressive cerebellar ataxia and positive cardiolipin antibodies?

Do you wait 12 weeks for confirmation to begin treatment if patient is declining?

1 Answer available

How would you counsel a patient with active SLE on treatment, low to moderate level of one of the APLS antibodies, and remote history of provoked blood clot regarding perioperative anticoagulation?

Is SLE-related APLS managed differently in terms of anticoagulation?

2 Answers available

Do you send an antiphospholipid antibody panel routinely for all patients with an unprovoked thrombus?

2 Answers available

Can APLS cause a false positive HIT ELISA?

If so, is there one type of antibody that is more likely to cause this false positive test?

1 Answer available

When considering the use of DOACs in APLS, does the number of positive APLS antibodies influence your decision?

2 Answers available

How do you interpret elevations in antiphospholipid antibodies that are lower than Sapporo criteria?

(e.g. beta 2 glycoprotein IgM > 20 but <40)

2 Answers available

Is there a role for immunosuppression in patients with triple positive antiphospholipid antibodies who do not meet the clinical criteria for APS?

2 Answers available

What is your preferred approach for patients with anti-phospholipid syndrome with recurrent thrombosis on coumadin and LMWH?

1 Answer available

Is there any role for direct oral anticoagulants in the treatment of antiphospholipid syndrome?

What if this was "triple-negative" antiphospholipid syndrome?

2 Answers available

For which subset(s) of APS patients do you recommend an INR of 3 or higher?

1 Answer available

Papers discussed in this category

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, 2016-04

Apixaban for the Secondary Prevention of Thrombosis Among Patients With Antiphospholipid Syndrome: Study Rationale and Design (ASTRO-APS).

Blood, 2018 Jul 12

Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome.

Ann. Intern. Med., 2019 Oct 15

Rivaroxaban Versus Vitamin K Antagonist in Antiphospholipid Syndrome: A Randomized Noninferiority Trial.

Annals of the rheumatic diseases, 2019-10

EULAR recommendations for the management of antiphospholipid syndrome in adults.

Diagnosis and Management of the Antiphospholipid Syndrome.

Journal of the American Society of Nephrology : JASN, 1993-07

Reversible renal failure in the primary antiphospholipid syndrome--a report of two cases.

Arthritis and rheumatism, 2013-02

A pilot open-label phase II trial of rituximab for non-criteria manifestations of antiphospholipid syndrome.

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2014-02

Eculizumab prevents recurrent antiphospholipid antibody syndrome and enables successful renal transplantation.

Lupus, 2018-03

Hydroxychloroquine in the primary thrombosis prophylaxis of antiphospholipid antibody positive patients without systemic autoimmune disease.

Lupus,

16th International Congress on Antiphospholipid Antibodies Task Force Report on Antiphospholipid Syndrome Treatment Trends.

Arthritis Rheum,

Risk factors for thrombosis and primary thrombosis prevention in patients with systemic lupus erythematosus with or without antiphospholipid antibodies.

Rheumatology (Oxford), 2021 May 18

Cognitive dysfunction and associated neuroimaging biomarkers in antiphospholipid syndrome: a systematic review.

Am J Transplant, 2013 Jun 13

Eculizumab improves posttransplant thrombotic microangiopathy due to antiphospholipid syndrome recurrence but fails to prevent chronic vascular changes.

Lancet Haematol,