What is Antiphospholipid Syndrome?

Antiphospholipid syndrome is a rare autoimmune disorder characterized by recurrent blood clots (thrombosis). Blood clots can form in any blood vessel in the body. You can find more information below.

What is antiphospholipid syndrome?

Antiphospholipid syndrome is an autoimmune disease that occurs when your immune system mistakenly makes antibodies that make your blood more likely to clot.

Related article: What is autoimmune disease, what does it mean?

Coagulation is caused by the presence of proteins in the blood called anti-phospholipid autoantibodies (commonly called aPL) that are created against one’s own tissues . These autoantibodies affect the normal clotting process and lead to increased clot formation or thrombosis (stopping of blood flow due to a clot).

The damage caused by this clot can vary depending on the site of the clot. For example, repeated small clots in the heart can cause the heart valves to thicken or become damaged, which means there is a risk of releasing clots into the blood ( called an arterial embolism ).

Autoantibodies (aPL) may also be associated with heart attack in young people without any known cardiac risk factors. Blood clots in the arteries of the heart can cause heart attacks, while blood clots in the arteries of the brain can result in a stroke. Blood clots made up of autoantibodies can form anywhere in the circulation and affect any organ in the body.

Clots that form in the veins are most common in the lower legs. Blood clots in the leg veins can break off, travel to the lungs and cause a very serious condition called a pulmonary embolism . Pulmonary embolism blocks blood flow to the lungs and reduces the amount of oxygen in the blood.

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In a few cases, repeated thrombotic events may occur over a short period of time, leading to progressive damage to several organs. This is an acute and life-threatening condition. Patients with antiphospholipid syndrome may suffer from other problems such as low platelet count, mottled purplish discoloration of the skin, and skin ulcers.

For pregnant women, antiphospholipid autoantibodies may put you at risk of early and late miscarriage and pregnancy poisoning. Autoantibodies are thought to be responsible for clots in the blood vessels of the placenta and cause fetal growth retardation. Autoantibodies can also directly attack placental tissues, inhibiting their growth and development.

What causes antiphospholipid syndrome?

It is not fully understood why patients develop anti-phospholipid autoantibodies (aPL). The production of these autoantibodies may have a genetic background and is triggered by an environmental factor such as an emerging infection that makes it more susceptible to disease.

Antiphospholipid autoantibodies can be found in the bloodstream for a long time, but thrombotic events occur only rarely. Autoantibodies increase the risk of blood clots, but thrombosis usually occurs when other conditions that trigger clotting are present, such as prolonged immobility, surgery, or pregnancy.

Additional risk factors for thrombosis are hypertension, obesity, smoking, atherosclerosis (hardening of the arteries), use of estrogen (birth control pills), and lupus , an associated systemic autoimmune disease .

What are the symptoms of antiphospholipid syndrome?

Symptoms of antiphospholipid syndrome may include:

  • Blood clots in the legs: This condition is commonly known as deep vein thrombosis. Symptoms include pain, swelling, and redness. These clots can also travel to your lungs.
  • Recurrent miscarriages or stillbirths: Other complications of pregnancy include dangerously high pregnancy intoxication and premature birth.
  • Stroke: A stroke can also occur in a young person with antiphospholipid syndrome but without a known risk factor for cardiovascular disease.
  • Transient ischemic attack: Similar to a stroke, a transient ischemic attack usually lasts only a few minutes and does not cause permanent damage.
  • Rash: Some people develop a red rash in pattern-like shapes.
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Less common symptoms include :

  • Neurological symptoms: There may be chronic headaches, including migraine. Dementia and seizures are also possible when a blood clot blocks blood flow to parts of your brain.
  • Cardiovascular disease: Antiphospholipid syndrome can damage the heart valves.
  • Bleeding: Some people have a decrease in blood cells necessary for clotting. This can cause episodes of bleeding, especially from your nose and gums.

When should you see a doctor?

You should consult your doctor if you have unexplained bleeding from your nose or gums. You should n’t waste time with an unusually heavy menstrual period, bright red or coffee grounds vomiting, black, tarry or bright red stools, or unexplained abdominal pain .

You should seek emergency help if you have symptoms of:

  • Stroke: A clot in your brain can cause sudden numbness, weakness, or paralysis in your face, arm, or leg. You may have difficulty understanding speech, visual disturbances, and severe headache.
  • Pulmonary embolism: You may experience sudden shortness of breath, chest pain, and coughing up blood.
  • Deep vein thrombosis: Symptoms of this include swelling, redness, or pain in the leg or arm.

How is antiphospholipid syndrome diagnosed?

If you’ve had unexplained blood clots or miscarriage with known health conditions, your doctor may schedule blood tests to check for abnormal clotting and the presence of antibodies to phospholipids.

To confirm a diagnosis of antiphospholipid syndrome, antibodies must appear in your blood at least twice in tests performed at intervals of 12 weeks or more.

You may have antiphospholipid antibodies and never develop any signs or symptoms. A diagnosis of antiphospholipid syndrome is made only when these antibodies cause health problems.

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How is antiphospholipid syndrome treated?

If you have blood clots, standard initial treatment includes a combination of blood-thinning medications. The most common are heparin and warfarin. Heparin is fast-acting and is given by injection. Warfarin comes in pill form and takes a few days to take effect. Aspirin is also a blood thinner.

When taking blood thinners, your risk of bleeding increases. Your doctor will monitor your dosage with blood tests to make sure your blood can clot enough to stop bleeding from a cut or bleeding under the skin.

Remember, your doctor will decide which medicine to take and how.

Lifestyle and home remedies

Depending on your treatment plan for antiphospholipid syndrome, there are additional steps you can take to protect your health. If you are taking blood-thinning medications, you should take extra care to avoid harming yourself and bleeding.

  • Avoid contact sports or other activities that could cause bruising, injury, or a fall.
  • Use a soft toothbrush and dental floss.
  • Shave with an electric razor.
  • Be very careful when using knives, scissors and other sharp tools.

Food and dietary supplements

Certain foods and medications can affect how your blood thinners work. Ask your doctor about the following:

  • Safe dietary options: Vitamin K may reduce the effectiveness of warfarin, but not other blood thinners. You may need to avoid eating large amounts of vitamin K-rich foods such as avocados, broccoli, Brussels sprouts, kale, leafy greens, and garbanzo beans. Cranberry juice and alcohol can increase the blood-thinning effect of warfarin. Ask your doctor if you should limit or avoid these drinks.
  • Safe medications and dietary supplements: Some medications, vitamins, and herbal products can interact dangerously with warfarin. These include over-the-counter pain relievers, cold remedies, stomach remedies or multivitamins, as well as garlic, ginkgo, and green tea products.

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