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Antiphospholipid Syndrome (APS)

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Pregnancy Management in APS

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Combination of low-dose aspirin and heparin (usually low molecular weight heparin) to reduce the risk of miscarriage and other complications.

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Main Clinical Manifestation of APS

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Thrombosis, which can occur in both arterial and venous systems, often leading to conditions such as deep venous thrombosis or stroke.

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Livedo Reticularis in APS

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A mottled discoloration of the skin often seen in APS patients, believed to be due to microvascular thrombosis.

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Antiphospholipid Antibodies

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Autoantibodies targeted against phospholipid-binding proteins including lupus anticoagulant, anticardiolipin antibodies, and anti-beta-2 glycoprotein I.

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Definition of APS

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An autoimmune disorder characterized by the presence of antiphospholipid antibodies causing thrombosis and/or pregnancy-related complications.

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APS Diagnostic Criteria

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Requires one clinical (vascular thrombosis or pregnancy morbidity) and one laboratory (presence of antiphospholipid antibodies) criterion for diagnosis.

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Common Obstetric Manifestation of APS

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Recurrent miscarriages, which are often seen as a hallmark of APS in the obstetric population.

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Management of Thrombotic Events in APS

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Long-term anticoagulation therapy is the mainstay treatment to prevent new thrombotic events, using vitamin K antagonists like warfarin or direct oral anticoagulants (DOACs).

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Primary vs Secondary APS

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Primary APS occurs in the absence of any other related disease, whereas Secondary APS is associated with another autoimmune disorder, commonly Systemic Lupus Erythematosus (SLE).

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Catastrophic APS

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A rare, severe form of APS characterized by multiple organ thromboses and a high risk of morbidity and mortality, requiring aggressive anticoagulation and immunosuppression.

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Thrombocytopenia in APS

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A common hematological finding in APS, usually mild and does not typically result in bleeding, despite low platelet counts.

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Pediatric APS

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Children can also be affected by APS, presenting similarly to adults with thrombosis and requiring similar management strategies.

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The Role of Immunoglobulins in APS

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Intravenous Immunoglobulin (IVIG) may be used in refractory APS, particularly in the setting of catastrophic APS or when anticoagulation alone is insufficient.

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Role of Aspirin in APS

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Used prophylactically in low-risk APS patients to reduce the likelihood of thrombotic events due to its antiplatelet effects.

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INR Target for Warfarin Therapy in APS

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The target INR in APS patients on warfarin is typically 2-3 for venous thromboembolism and 2.5-3.5 for arterial thrombosis.

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