Saturday, September 10, 2011

Antiphospholipid syndrome-signs treatment and prevention

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Antiphospholipid syndrome is an autoimmune disorder caused by the production of antibodies against a cell membrane substance, phospholipids. This antiphospholipids causes coagulation in arteries and veins causing problems associated with blood clots. Anti-phospholipids syndrome may occur in conjunction with other autoimmune diseases.

Antiphospholipid syndrome-gangrene

Anti-phospholipids syndrome causes blood clots in arteries and veins resulting in related health problems and pregnancy related complications like miscarriage, stillbirth, severe pre-ecclampsia and pre-term delivery. This disease is also called as Hughes syndrome which is named after Dr. Graham R. V. Hughes, a famous rheumatologist in London.

Incidence

As in many other autoimmune disorders, women are more affected than men. This disease can occur at any age group. This disease can have a genetic predisposition.

Signs and symptoms

Complications associated with clots in veins and arteries like deep vein thrombosis and stroke.

Antiphospholipid syndrome-signs

Pregnancy related complications like miscarriage, stillbirth, severe pre-ecclampsia and pre-term delivery. Miscarriage occurs before 20th weeks of gestation and pre-ecclampsia after that.

Mental and physical developmental problems occurs in newborn of affected mothers.
Other complications are thrombocytopenia (Low platelet count), headaches, Migraine, heart valve disease and livedo reticularis (a skin condition)

Diagnosis

Laboratory tests include liquid coagulation assays and ELISA assays for anti-cardiolipin antibodies.

Differential diagnosis is done by Factor V Leiden variant test, Factor VIII levels, Prothrombin mutation test and C-reactive protein for differentiating it from Genetic thrombocytopenia.

Pathogenesis

It is an autoimmune disease, caused by formation of antibodies against phospholipids. These antibodies react against proteins of plasma membrane. The exact cause for the formation of antibodies is not known. But this reaction causes activation of coagulation system. This leads to conditions associated with clot formation.

Treatment

Aspirin or warfarin is given to treat this disease. Aspirin and warfarin are anticoagulants which prevents the formation of blood clots. These medications are given only when the patient is presented with symptoms associated with clot formation.
During pregnancy, warfarin is not recommended because of its teratogenic effects. Low molecular weight heparin and low dose aspirin are used in pregnancy. These medications should be started immediately after missing first menstrual cycle.

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