Signs and Symptoms
Deep venous thrombosis is the most common type of thrombosis, occurring in approximately one-third of patients with APS. Episodes of thrombosis can recur, particularly in patients with high antiphospholipid antibody titers. Patients may also have pulmonary embolism and superficial thrombophlebitis. CNS disease can include strokes, transient ischemic attacks, dementia, and even psychosis. APS should be considered when thrombosis or cerebrovascular disease occurs in a young patient without other risk factors for stroke.
This syndrome can cause complications during pregnancy. Patients may have multiple first-trimester spontaneous abortions and premature births due to preeclampsia or placental insufficiency; late-term fetal death may also occur.
Other manifestations of APS include thrombocytopenia, hemolytic anemia, nephropathy, and livedo reticularis. Cardiac manifestations include valvular thickening and nodules (Libman-Sacks endocarditis). In rare instances, a severe form of APS can occur with multiple vessel occlusions and multiorgan failure. This form of the disease is called catastrophic antiphospholipid syndrome and has a mortality rate of 48%.
Excerpted from BCSC 2020-2021 series: Section 1 - Update on General Medicine. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.