Antiphospholipid syndrome resident survival guide

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Antiphospholipid syndrome
Resident Survival Guide
Overview
Causes
FIRE
Diagnosis
Treatment
Do's
Don'ts


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

Causes

The causes of antiphospholipid syndrome are as follows:

Autoimmune diseases Infections Drugs Malignancy
  • Systemic lupus erythmatosus(SLE)
Bacterial infections:
  • Leptospirosis[1][2]
  • Syphilis
  • Lymes disease
  • Tuberculosis[3]
  • Leprosy
  • Infective endocarditis
  • Post-Streptococcal rheumatic fever
  • Klebsiella infection

Viral infections:

  • Hepatitis A,B and C
  • HIV
  • Ebstein Barr virus
  • Adenovirus
  • Rubella
  • Parvovirus
  • Cytomegalovirus
  • Varicella Zoster virus

Parasitic infections:

  • Visceral leischmaniasis
  • Pneumocysitis jirovecci
  • Malaria
  • Chlorpromazine
  • Procainamide
  • Hydralazine
  • Quinidine
  • Quinine
  • Phenytoin
  • Alpha interferon
  • Oral contraceptives
  • Amoxicillin
  • Chlorothiazide
  • Propanolol
Tumors of the following organs can cause APS:
  • Lung
  • Colon
  • Breast
  • Cervix
  • Ovary

Cancers:

  • Hodgkins lymphoma
  • Non-hodgkins lymphoma
  • Myeloid leukemia
  • Lymphocytic leukemia
  • Primary myelofibrosis
  • Polycythemia vera

FIRE

Diagnosis

Treatment

  • Treatment of acute thrombosis
  • Treatment of recurrent thrombosis despite anticoagulation
  • Anticoagulation in pregnancy
  • Treatment of refractory cases in pregnancy

Do's

Don'ts

References

  1. McNeil HP, Chesterman CN, Krilis SA (1991). "Immunology and clinical importance of antiphospholipid antibodies". Adv Immunol. 49: 193–280. PMID 1853785.
  2. Safa O, Crippa L, Della Valle P, Sabbadini MG, Viganò D'Angelo S, D'Angelo A (1999). "IgG reactivity to phospholipid-bound beta(2)-glycoprotein I is the main determinant of the fraction of lupus anticoagulant activity quenched by addition of hexagonal (II) phase phospholipid in patients with the clinical suspicion of antiphospholipid-antibody syndrome". Haematologica. 84 (9): 829–38. PMID 10477458.
  3. Triplett DA (1998). "Many faces of lupus anticoagulants". Lupus. 7 Suppl 2: S18–22. PMID 9814666.