Primary Care

Antiphospholipid Syndrome

Questions discussed in this category

How often should lupus anticoagulant be checked in patients with SLE if prior was negative or if prior was positive?

1 Answer available

How would you manage a patient with SLE that has a remote history of positive anti-phospholipid antibodies with a current DVT and now completely negative APLs?

Would you still plan for lifelong anticoagulation in this scenario?

1 Answer available

Would you start anticoagulation in a patient with provoked blood clot in the past now with labs done for rheumatological reasons showing triple positive APLA?

If so, would you start immediately or wait for the second set of labs to confirm before initiating blood thinners?

3 Answers available

How would you approach a woman with APLA but no thrombosis/APLS, a history of ITP without bleeding who is now pregnant?

2 Answers available

Do you recommend starting aspirin for a patient with ESKD secondary to lupus nephritis with detected antiphospholipid antibodies on pretransplant workup but no history of a thrombotic event?

3 Answers available

Would you start anticoagulation in a patient with a history of CVA 1 year ago and high risk APL profile who was never started on anticoagulation, but is now presenting for follow up and without recurrent thrombotic events?

The patient has no known history of autoimmune disease.

4 Answers available

What would be your approach to a SLE patient who is triple APS positive, has no prior VTE/obstetric events, is stable on HCQ and low dose aspirin, and wants to become pregnant?

2 Answers available

In a patient with APS and obesity during pregnancy when switched to LMWH, do you cap the dose of dalteparin as per manufacturers labeling at 18,000U per day or do you use weight based dosing?

1 Answer available

How would you approach a low to moderate titer of one of the APLS antibodies in a patient with a strong family history but no personal history of thrombosis?

Although testing was not indicated, what do u do with these results? Other hypercoagulability work up negative

2 Answers available

Would you discontinue anticoagulation in patients with antiphospholipid antibody syndrome, who have a remote history of thrombotic events and are now negative for pathogenic antiphospholipid antibodies?

Would the answer differ if the index event was arterial vs venous?

3 Answers available

Would you consider thrombophilia testing in a pregnant patient with VTE?

If work-up is sent and the patient is found to have a persistently positive antiphospholipid antibody, particularly lupus anticoagulant, would you con...

2 Answers available

How would you approach a young patient with a history of APLS and VTE, desiring hormone replacement therapy after oophorectomy?

Currently on nonwarfarin therapeutic anticoagulation

1 Answer available

Is there a role for low dose aspirin in a patient with AVN in four large joints who has underlying well-controlled SLE and positive APLs but no history of clots?

1 Answer available

Do you offer anticoagulation to patients with prior antiphospholipid antibodies detected in pregnancy without a history of pregnancy loss or thrombosis?

What is the risk of pregnancy loss in absence of anticoagulation? What would you suggest if the patient had anticoagulation in prior pregnancies and r...

3 Answers available

How long would you consider the use of low-dose aspirin in a patient with SLE and high risk aPL profile (without a clinical event)?

1 Answer available

In a patient identified as having APLS because of recurrent pregnancy loss without history of thrombosis, but now has a new DVT/PE during pregnancy despite use of enoxaparin—for how long would you recommend anticoagulation?

Is it time limited since it may have been triggered by the pregnancy or is it indefinite since it is APLS associated?

2 Answers available

Do you repeat antiphospholipid antibody testing in a patient that previously met criteria for APLS?

If so, how long after diagnosis do you do so?

1 Answer available

Do you ever consider treatment outside of the peripartum period in a patient with a history of obstetric APS?

i.e. obstretric APS without thrombosis or SLE

2 Answers available

What is your approach to a patient with positive antiphospholipid antibodies who otherwise do not meet clinical criteria for APS?

What if the patient is triple-positive or has continued seropositivity on repeat lab testing? What is the appropriate interval of monitoring and does ...

3 Answers available

Do you recommend COVID vaccination in patients with antiphospholipid antibody positivity or other prothrombotic states not on anti-coagulation?

1 Answer available

Do you consider low-dose aspirin for primary thromboprophylaxis in patients with high-risk antiphospholipid antibody profiles?

While low-dose aspirin for primary thrombosis prevention in aPL without APS is not typically recommended outside cardiovascular prevention guidelines ...

1 Answer available

How do you approach the use of low-dose aspirin for primary prevention in non-pregnant patients with SLE and positive aPL antibodies, without clinical criteria for APS?

Do you follow the 2019 EULAR Guidelines that SLE patients with asymptomatic, positive aPL should be on low-dose ASA?

1 Answer available

Do you check pertussis serologies when sending labs for antiphospholipid syndrome?

2 Answers available

Papers discussed in this category

Ann Rheum Dis,

Antiphospholipid antibodies and infections.

Thromb Res, 2021 Jun 25

Absence of hypercoagulability after nCoV-19 vaccination: An observational pilot study.

Current rheumatology reports, 2018-09-10

Primary Thrombosis Prophylaxis in Persistently Antiphospholipid Antibody-Positive Individuals: Where Do We Stand in 2018?

Nat Rev Cardiol, 2019 Jun 26

Role of aspirin in primary prevention of cardiovascular disease.

Autoimmun Rev, 2017 Sep 09

Can we withdraw anticoagulation in patients with antiphospholipid syndrome after seroconvertion?

J Rheumatol, 2017 May 15

Longterm Hydroxychloroquine Therapy and Low-dose Aspirin May Have an Additive Effectiveness in the Primary Prevention of Cardiovascular Events in Patients with Systemic Lupus Erythematosus.

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Diagnosis and Management of the Antiphospholipid Syndrome.

Lupus Sci Med, 2018 Sep 25

Obstetric antiphospholipid syndrome.

Arthritis and rheumatism, 2012-07

Prediction of adverse pregnancy outcome by the presence of lupus anticoagulant, but not anticardiolipin antibody, in patients with antiphospholipid antibodies.

Autoimmunity reviews, 2017 Feb 13

Antiphospholipid antibodies disappearance in primary antiphospholipid syndrome: Thrombosis recurrence.

Thrombosis research, 2023 Feb 10

Recurrent thrombotic events after disappearance of antiphospholipid autoantibodies: A long-term longitudinal study in patients with antiphospholipid syndrome.

Lupus, 2017 Mar 29

Cessation of oral anticoagulants in antiphospholipid syndrome.

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