Antiphospholipid syndrome or antiphospholipid syndrome(APS) is set of symptoms that happened consequence system the immune system attacks fat compounds body called phospholipids. The most characteristic sign of santiphospholipid syndrome is an increase in blood viscosity.
Antiphospholipid syndrome is also known as Hughes syndrome, after its discoverer. This syndrome is classified as an autoimmune disease that can cause disorders in all parts of the body.
Phospholipids are body fat compounds that build all cell walls in the human body. Phospholipids also play a major role in the process of blood clotting by platelets. Therefore, blood clots are one of the most common signs of this condition.
Causes of Antiphospholipid Syndrome
In antiphospholipid syndrome, the immune system (immune system) that is supposed to fight foreign organisms, such as viruses or bacteria, mistakenly produces antibodies that attack phospholipids.
The cause of the formation of these antibodies or how these antibodies cause blood clotting is not known with certainty. However, it is suspected that these antibodies are formed due to genetic mutations in the immune system, certain viral or bacterial infections, certain medications, or a combination of the three.
There are several factors that can increase a person's risk of developing antiphospholipid syndrome, namely:
- Female gender
- Have another autoimmune disease, such as lupus or Sjögren . syndrome
- Have certain infections, such as hepatitis C, HIV/AIDS, or syphilis
- Taking certain medications, such as the anticonvulsant phenytoin or the antibiotic amoxicillin
- Have a family history of antiphospholipid syndrome
Recent research has also revealed the discovery of antibodies that attack phospholipids in COVID-19 patients. This is thought to be related to blood clots that occur in COVID-19 patients with severe symptoms. However, this still needs further research.
In some cases, a person may have antibodies that attack phospholipids in their blood without experiencing any health problems. Even so, people with this condition will still be at risk of experiencing symptoms if:
- Currently in pregnancy
- Have high blood cholesterol levels
- Having surgery, especially on the legs, such as knee or hip replacement surgery
- Have a smoking habit
- Undergoing hormone replacement therapy or taking birth control pills
- Being overweight or obese
- Not moving for a long period of time, for example because you are at bed rest after surgery or sitting down during a long-haul flight
Symptoms of Antiphospholipid Syndrome
Antiphospholipid syndrome causes the blood to become thicker or clot more easily. This increases the risk of blockage of blood flow in the arteries and veins.
Blood clots that form can cause APS sufferers to experience:
- Deep vein thrombosis (DVT) or deep vein thrombosis
- Pulmonary embolism
- Rashes or sores on the skin
- Heart attacks or strokes, especially those that are recurrent and occur under the age of 55 for men and under 65 for women
- Blockage of blood vessels in the eyes, liver, or kidneys
- Pregnancy complications, such as recurrent miscarriage or premature birth caused by severe preeclampsia or eclampsia
In addition, antiphospholipid syndrome is also known to cause heart valve disorders, nervous system disorders, and thrombocytopenia.
The above conditions can be recognized by symptoms, such as:
- Frequent tingling in the feet or hands
- Fatigue and weakness
- Recurrent headaches
- Visual disturbances, such as double vision
- Memory disorder
- Speech disorders
- Movement and balance disorders
- Bruises or sores on the skin
- Nosebleeds and bleeding gums
When to go to the doctor
Check with your doctor if you experience the above symptoms without a clear cause, especially if the symptoms are frequent and bothersome.
Immediately visit the ER or the nearest doctor if you suddenly experience an emergency health problem, such as:
- Stroke, which is characterized by a severe headache, muscle weakness or numbness on one side of the body, difficulty speaking, or difficulty understanding other people's words
- Pulmonary embolism, which is characterized by shortness of breath, chest pain when breathing in, and coughing up blood
- Deep vein thrombosis, which is characterized by swelling, redness, and pain in the calf or arm
Antiphospholipid Syndrome Diagnosis
To diagnose antiphospholipid syndrome or APS, the doctor will ask and answer questions about the symptoms experienced by the patient, the history of the patient's and family's health conditions, and the medications being used. After that, the doctor will perform a thorough physical examination.
If the patient has a blood clot that causes the health problems mentioned above and without a clear cause or risk factor, the doctor will perform a blood test to confirm the presence of antibodies that cause APS.
Blood tests will be done 2 times. Patients can be diagnosed with antiphospholipid syndrome if both tests show antibodies that cause APS.
In addition to antibody tests, doctors can also perform the following tests to make a more accurate diagnosis:
- General check up
- Syphilis test
- Blood clotting check
- Lupus antibody test Anti-beta-2 glycoprotein I
Radiological examinations are also needed to detect problems that may occur due to blood clots in the body, such as an MRI of the brain to see a stroke, or a Doppler ultrasound of the legs to see if there is a blood clot. deep vein thrombosis (DVT).
Antiphospholipid Syndrome Treatment
There are several methods that can be used to treat antiphospholipid syndrome, namely:
Prevention of blood clots
Because they have a tendency to develop blood clots, people with APS need to regularly take blood-thinning medications, such as low-dose aspirin or clopidogrel, to prevent this from happening. If taking birth control pills, APS sufferers will be advised to replace them with other contraceptive methods, such as the IUD.
In addition, the risk of blood clots can also be reduced by making lifestyle changes, such as:
- Maintain ideal body weight
- Limit foods high in fat and sugar
- Exercise regularly
- Quit smoking
- Avoid alcohol consumption
Treatment of blood clots
If a person with APS has had blood clots before, the doctor will prescribe anticoagulant drugs, such as warfarin, in the form of tablets. However, if the symptoms of a blood clot suddenly become severe, people with APS may need to receive an injectable anticoagulant, such as heparin.
Treatment in pregnancy
Treatment or prevention of blood clots in pregnant women who suffer from APS syndrome is generally done by giving a combination of injectable heparin drugs and low-dose aspirin. However, the dose and time of administration will vary, depending on the risk factors that pregnant women have.
In addition to the above treatment methods, immunosuppressant drugs, such as corticosteroids or rituximab, can also be used to treat APS syndrome in patients with low platelets (thrombocytopenia), have skin lesions, or have other autoimmune diseases, such as lupus.
Complications of Antiphospholipid Syndrome
Catastrophic antiphospholipid syndrome (CAPS) is a serious complication of the antiphospholipid syndrome (APS). Although it only occurs in 1% of patients with APS, this complication needs to be watched out for because it can lead to death.
In CAPS, blood clots will form throughout the body, resulting in the failure of the body's organs to function at the same time. It is not clear how this complication occurs, but it is suspected that the trigger is infection, injury, and surgery.
CAPS can be recognized by the following symptoms:
- Blue finger tips
- Crowded
- Stomach pain
- Bloody urine
- Seizures
- Loss of consciousness
These symptoms usually appear suddenly and worsen very quickly.
Prevention of Antiphospholipid Syndrome
Antiphospholipid syndrome is a type of disease that is difficult to prevent because the exact cause is unknown. The best prevention effort that can be done is to avoid factors that can increase the risk of this disease.
Performing regular health checks before any complaints can also be a good prevention for people with autoimmune diseases or people who have a family history of autoimmune diseases or antiphospholipid syndrome.
