APS produces abnormal antibodies that attack the proteins on phospholipids, which then tend to clump together to form blood clots. — Positive Parenting
Not many people have heard of it, even doctors!
It is not something you study deeply about in medical school.
But it exists. It is one of the autoimmune diseases.
This is a condition where your own immune system attacks your own tissues in your body.
The hallmark of this disease, also known as sticky blood syndrome, is that your own antibodies can form blood clots in your blood vessels.
These blood clots can then give you complications like heart attack, stroke, etc.
In antiphospholipid syndrome (APS), your immune system makes certain abnormal antibodies.
Most of the time, antibodies are supposed to protect your body against infection and foreign invaders.
But this time, your immune system forms antibodies that attack proteins bound to phospholipids.
Phospholipids are a type of fat cell in your body.
The abnormal antibodies formed are:
- Lupus anticoagulant (like the type you get in systemic lupus erythematosus or SLE)
- Anticardiolipin, and
- Anti-B2-glycoprotein 1.
The attacks cause the damaged phospholipids to stick to one another, clump and form clots.
If you have APS, you can have either one, two or all three of these antibodies.
Like many autoimmune diseases, no one quite knows exactly what causes the antibodies to form.
But there are certain risk factors, such as if you are female, are between 30 to 40 years old, have other autoimmune diseases like SLE and rheumatoid arthritis, and have family members with APS.
It is not a common disease.
Generally speaking, when you present with a certain symptom, the doctor tries to find out the cause of that symptom by going down a long list of what can possibly cause it.
Most people who have APS don’t have any symptoms at all.
But when they do, they usually present with a complication from a blood clot.
These can be like:
- Chest pain (angina or a heart attack)
- Breathlessness (heart issues as above, or even a lung embolism)
- Headache (blood clot in the brain)
- Sudden pain in the jaw, neck or back
- Stroke, especially in a young person without risk factors like high blood pressure
- Transient ischaemic attack
- Deep vein thrombosis, where there is a sudden pain in an arm or a leg (depending on where the blood clot travels to and gets stuck)
- Sudden abdominal pain (blood clot in the stomach, intestine or abdominal area)
- Symptoms of damaged heart valves
- Unexplained bleeding due to low platelet levels.
Some people with APS have mottled skin called livedo reticulitis.
This causes a lattice-like pattern that looks like cobwebs.
It is caused by blood clots forming and bleeding occurring in your skin.
Some people experience blood clots during pregnancy.
When you have APS in pregnancy, you are at high risk for a clot to form in the placenta.
Some women with APS have repeated miscarriages and stillbirths.
These movements are called chorea.
They are unusual, but can present in 2% of APS cases.
It is postulated that the antibodies attack the basal ganglia in the brain, leading to dysfunction.
Chorea can be extremely uncomfortable and may interfere with eating and speaking, especially when it affects the tongue.
It is a rare symptom of any autoimmune disease, not just APS.
It is not usually one of the diseases you screen for, or can detect easily, because it is such an unusual condition.
But it is one of the causes of low platelet counts.
So when you have a low platelet count and the doctor cannot find any infection that causes this, APS is one thing you should screen for, especially if you are a youngish woman with no other risk factors.
You can screen your blood for those antibodies we spoke about.
If at least one of those three antibodies comes back positive in two tests done three months apart, then you will be diagnosed as having APS.
There is no cure, but its complications can be controlled with lifelong blood thinner medications to lessen your chances of having clots.
To suppress your immune system, you can also take steroids.
It is possible to have a successful pregnancy if you have APS, but your doctor must monitor you carefully and give you heparin or aspirin.
Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
