Submitted October 13, 2006
Accepted June 19, 2007
How we diagnose and treat thrombotic manifestations of
the antiphospholipid syndrome: a case-based review
David A Garcia, Munther A Khamashta, and Mark A. Crowther*
Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, United States
Lupus Reasearch Unit, the Rayne Institute, King's College London School of Medicine at Guy's, King's & St. Thomas' Hospitals, London, United Kingdom
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
* Corresponding author; email: crowthrm{at}mcmaster.ca.
Antiphospholipid syndrome (APS) is a prothrombotic disorder predisposing to thrombocytopenia, recurrent pregnancy morbidity and thrombosis. This review will focus on the management of selected patients with, or at risk of, thromboembolism in the setting of known, or suspected, antiphospholipid antibodies (aPL), including patients meeting consensus conference criteria for APS.
Although there remain many unanswered questions around the diagnosis and management of such patients, recent evidence does provide some guidance for their management. To avoid duplicating recent reviews 1-3, we present our opinions in a series of cases that illustrate typical clinical presentations. For clinical questions about which evidence is lacking, we offer our opinion about diagnosis or treatment options. We have, throughout the text, tried to clarify whether the strategy we endorse is supported by published evidence or is experientially based.
