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The Antiphospholipid Syndrome: What are We Really Measuring? How do We Measure it? And How do We Treat it?

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Abstract

The antiphospholipid syndrome is described with a review of its historical development as a recognized syndrome, what constitutes an antiphospholipid antibody, how it is measured, and how the syndrome is treated. Antiphospholipid antibodies are actually antibodies to a protein, most often beta-2-glycoprotein 1, that is usually bound to a phospholipid. Some antibodies are directed towards lipid-bound prothrombin. The antibodies are measured by immunologic assays or by antibody-dependent abnormalities detected in coagulation assays. Although they prolong coagulation assays, they are associated with a thrombotic tendency rather than a bleeding disorder. There are numerous postulated mechanisms to account for the thrombotic tendency. Patients with the antiphospholipid syndrome are treated with long-term oral anticoagulation to prolong the INR to 2.0 to 3.0. For most patients, a more intense level of treatment with a higher INR is not needed.

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Authors and Affiliations

  1. Division of Hematology, Departments of Medicine and Pathology, Duke University Medical Center, Durham, NC, Box 3422, 27710

    Thomas L. Ortel M.D., Ph.D.

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  1. Thomas L. Ortel M.D., Ph.D.
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Correspondence to Thomas L. Ortel M.D., Ph.D..

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Supported by a cooperative agreement (U18 DD00014) with the Hematologic Diseases Branch, Centers for Disease Control and Prevention, and a grant (U54-HL077878) from the National Institutes of Health.

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Ortel, T.L. The Antiphospholipid Syndrome: What are We Really Measuring? How do We Measure it? And How do We Treat it?. J Thromb Thrombolysis 21, 79–83 (2006). https://doi.org/10.1007/s11239-006-5581-x

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  • DOI: https://doi.org/10.1007/s11239-006-5581-x

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