Antiphospholipid syndrome (APS) is associated with antiphospholipid antibodies, which increase the risk of blood clots and other serious complications, including recurrent miscarriages. These antibodies were first identified in the 1980s by Dr. Graham Hughes and his team, who discovered that they target key components of cell membranes, such as phospholipids. Continue reading to learn about APS, its symptoms, diagnostic tests and more.
Antiphospholipid Syndrome (APS) is a rare autoimmune disorder in which the immune system mistakenly produces antibodies that increase the risk of blood clots. Normally, the immune system creates antibodies to fight off harmful invaders like bacteria and viruses. But, in APS, antiphospholipid antibodies are produced that target the body's own cells, leading to complications such as stroke, heart attack, miscarriage, and other serious health issues.
When you have APS, the immune system produces antibodies that mistakenly attack the body's cells, causing cell damage and increasing the risk of blood clots in veins and arteries. These clots can form anywhere in the body, including the brain, lungs, and legs. While APS has no cure, treatment can help prevent clot formation and reduce the risk of serious complications.
The most common APS symptom is blood clots. Their symptoms and signs vary based on where the clots are formed. There may be:
● Chest pain
● Shortness of breath
● Nausea
● Swelling, redness, or pain in the arms or legs
● Speech pattern changes
● Discomfort in the jaws, arms, neck and back
● Bleeding from the gums or nose due to a low platelet count
● Anaemia
● Rash with a purple or red pattern on the skin
● Damage to the heart valves
● Memory problems
● Frequent headaches
●DVT (Deep vein thrombosis): occurs when blood clots form in the deep veins (which carry blood toward the heart). It can happen in the legs, arms and pelvis.
● Pulmonary embolism: A blood clot in the lungs blocks the arteries and causes life-threatening conditions like pulmonary embolism. It typically happens after a clot breaks in the deep leg vein and travels to the lungs. APS can also cause high blood pressure in the lungs.
● Heart attack: A heart attack is when a blood clot blocks the arteries in the heart and prevents the normal flow of oxygen and blood.
● Stroke: This happens due to clots in the brain and leads to paralysis, loss of speech and other complications. APS can lead to a mini-stroke or a less severe transient ischemic attack (TIA).
● Kidney damage: Restricted blood circulation to the kidneys results in problems like kidney failure.
Serious APS is dangerous but rare. Dangerous complications may happen when blood clots form suddenly in a short span, which may damage many organs. The exact reason for this is unknown, but it may be due to surgery, injury or infection.
APS affects women five times more than men and is often diagnosed in their 30s. This is the primary reason it is associated with pregnancy-related issues. Also, during pregnancy, there is an increased risk of blood clots even if APS antibodies are not present, as there is an increase in blood flow to support the fetus. This adds more pressure on the blood vessels, making them narrower. Complications during pregnancy associated with APS include:
● High blood pressure (preeclampsia)
● Death of fetus in womb
● Inability to get pregnant
● Miscarriage typically occurs after the 10th week.
● Birth of underweight or small babies
● Premature birth (before 34th week)
APS occurs when the immune system mistakenly makes abnormal antibodies. Typically, antibodies are special proteins that protect you by destroying toxins, germs, and allergens in the blood. When the immune system finds an unwanted substance in the blood, it creates customised antibodies to destroy it.
The name "Antiphospholipid Syndrome" comes from the presence of antibodies that mistakenly target phospholipids — fat molecules that are essential components of cell membranes — or proteins bound to them. These antibodies interfere with the normal function of the blood and vascular system, increasing the risk of abnormal clot formation. The three main types of antiphospholipid antibodies associated with APS are:
● Anti-beta-2 glycoprotein I (anti-β2GPI)
● Anticardiolipin antibodies
● Lupus anticoagulant
Individuals with APS may have any combination of these antibodies or sometimes none at all. Occasionally, they may not show symptoms even if these antiphospholipid antibodies are present. The exact reason why the immune system starts producing antiphospholipid antibodies is still unknown. However, once these antibodies are present, they can lead to the development of APS and increase the risk of serious complications like blood clots and pregnancy loss.
While APS can affect anyone, certain factors can increase your risk:
● You're a woman
● You have infections like Hepatitis C, HIV, syphilis, or Lyme disease
● You take medications for seizures, blood pressure, or heart rhythm
● You have an autoimmune condition such as lupus
● A close family member has been diagnosed with APS
Even if you already carry antiphospholipid antibodies, certain situations can trigger symptoms or increase your risk of blood clots:
● Obesity
● Pregnancy
● Recent surgery
● Use of birth control pills
● High blood pressure or high cholesterol
● Smoking
● Sitting for long hours without movement
Understanding these risk factors can help you stay alert and take preventive steps. If you fall into any of these categories, it's worth discussing your risks with a healthcare provider.
Experts opine that the cause of miscarriages in women with APS is placental blood clots. The placenta is an organ that provides oxygen and nutrition to the growing fetus during pregnancy. Clots in the placenta may block the flow to the umbilical cord and the fetus, causing miscarriage.
Antiphospholipid Syndrome (APS) is often diagnosed after a person experiences a blood clot or recurrent miscarriages, prompting further investigation through specific blood tests. Some people do not experience any complications or symptoms despite having antiphospholipid antibodies. Blood tests are the best way to diagnose APS. Blood samples are drawn for the three antiphospholipid antibodies. Three different blood tests are done to screen for each of them. If at least one blood test is positive twice, continuously done three months apart, you are diagnosed with APS.
There is no cure for APS, but treatment can reduce the risk of blood clots and prevent the formation of new clots. The standard treatment is a combination of anticoagulants (blood thinners). Most people are prescribed a shot of fast-heparin and a blood thinner that is slow-acting in pill form. Because these medications can increase the risk of bleeding, your doctor will closely monitor your condition and adjust the dosage if needed.
If you are pregnant, to prevent miscarriages, you will be given IVIG (intravenous immunoglobulin), enoxaparin and corticosteroids to suppress the immune system and reduce inflammation. These treatments are safe for both the mother and the baby.
APS is an autoimmune blood clotting disorder resulting in blood clots anywhere in the body. This leads to many health complications, including miscarriages. While there is no cure, blood thinners and other medications can prevent complications, and you can lead a normal life.
Antiphospholipid syndrome is an immune system disorder where the body makes antibodies that attack phospholipid-bound proteins, causing blood clots.
APS triggers blood clots in the veins and arteries by making antiphospholipid antibodies that attack phospholipid-bound proteins.
Chest pain, shortness of breath, nausea, swelling, redness or pain in the arms or legs, bleeding from the gums or nose due to a low platelet count and anaemia are some early signs of APS.
Early detection of APS is vital to prevent serious complications like heart attack, kidney failure, and stroke.
