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Antiphospholipid Syndrome (APS/Hughes syndrome) is an autoimmune, hypercoagulable state caused by antibodies against cell-membrane phospholipids. The most common of these antibodies, lupus anticoagulant (LA) and anticardiolipin antibodies (aCL), are the basis of laboratory diagnosis. Primary Antiphospholipid Syndrome - thrombosis or multiple pregnancy loss with the laboratory findings of persistent paradoxical prolongation of activated partial thromboplastin time (aPTT) or high titers of aCL antibodies. Secondary Antiphospholipid Syndrome: associated with other autoimmune diseases, infection, drugs, and malignancy. Primary and secondary APS can result in venous or arterial thrombosis in virtually any location; lower extremity deep vein thrombosis (DVT) is the most common presentation. Thrombotic stroke/transient ischemic attack (TIA) is the leading arterial manifestation of APS. Up to 46% of stroke patients <50 years old have antiphospholipid antibodies.