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Antiphospholipid syndrome

Author: DAVID P JOHNSON MB ChB FRCS FRCS. MD
Consultant Orthopaedic Surgeon

Antiphospholipid syndrome (APS) is a disorder in which the blood has a tendency to clot too quickly, know as ‘sticky blood’ syndrome. The clotting can affect any vein or artery in the body, resulting in a wide range of symptoms. These are described below.

What are the main signs and symptoms?
There are two main problems caused by APS, firstly blood clotting (thrombosis) and secondly, in women, a tendency to miscarriage. It is important to recognise that in APS, as distinct from other clotting disorders, the thrombosis can occur in the arteries (more serious) as well as in the veins.

In APS blood clotting may affect the brain. Symptoms include headaches, memory loss/forgetfulness, slurred speech, mental sluggishness and fatigue, visual disturbances and seizures (fits). It is estimated that 1 in 5 people under 40 years old who suffer from strokes may have APS. Some people with APShave symptoms that mimic multiple sclerosis – but there is otherwise no connection between APS and multiple sclerosis.

Deep vein thrombosis (DVT) of the leg is the commonest type of vein thrombosis. Apart from APS this can sometimes occur after surgery or long flights or in women taking the contraceptive pill.  DVT in the leg causes pain and swelling in the calf. The whole leg may become swollen and tight. The diagnosis should be confirmed in hospital by tests such as ultrasound. The major concern in patients with a DVT is the risk of a small piece of blood clot travelling to the lungs (pulmonary embolism). Other internal organs, such as the kidney and liver, can also be affected by thrombosis.

APS may affect the heart. There are two main areas of the heart which can be affected: the heart valves and the coronary arteries which supply blood to the heart muscle. The heart valves may become thickened and fail to work properly. The coronary arteries may also become thicker, leading to angina.
Kidney disease in APS can cause narrowing of the blood vessels to the kidney and this may cause high blood pressure.

Link – http://www.arc.org.uk/arthinfo/patpubs/6059/6059.asp

Editor: David P Johnson MD.
St Mary’s Hospital. Clifton Bristol. BS8 1JU.
Web site: www.orthopaedics.co.uk
boc@orthopaedics.co.uk
© OrthopaedicsOpinionOnline 2011 www.OrthopaedicOpinionOnline.co.uk

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