What is Antiphospholipid Syndrome?
Antiphospholipid syndrome is an autoimmune clotting disorder in which antibodies against phospholipid-binding proteins make the blood abnormally prone to thrombosis in both arteries and veins.
It causes deep vein thrombosis, pulmonary embolism, stroke in young adults, and a distinctive pattern of pregnancy loss — particularly miscarriage after ten weeks, severe pre-eclampsia and placental insufficiency.
APS can occur alone or alongside lupus. It is one of the very few genuinely treatable causes of recurrent miscarriage, which makes correct diagnosis enormously consequential.
IllustrativeSymptoms of Antiphospholipid Syndrome
Early signs
- Deep vein thrombosis — a painful, swollen calf
- Stroke or transient ischaemic attack in someone under 50 without usual risk factors
- Recurrent early miscarriage, or fetal loss after ten weeks
- Livedo reticularis — persistent purple net-like mottling of the skin
- An unexplained low platelet count
If left untreated
- Recurrent clots despite anticoagulation
- Cognitive difficulty, migraine or seizures
- Heart valve thickening or vegetations
- Kidney impairment from small-vessel thrombosis
- Catastrophic APS — multi-organ thrombosis over days, a medical emergency
Causes & risk factors
- Autoantibodies against beta-2 glycoprotein I, cardiolipin and prothrombin complexes
- Association with lupus and other autoimmune disease
- Transient antibody positivity after infection — which is why repeat testing is mandatory
- Genetic predisposition, amplified by smoking, oestrogen-containing contraception and immobility
How Antiphospholipid Syndrome is diagnosed
No single test diagnoses a rheumatic disease. The diagnosis comes from combining the pattern of symptoms, the examination findings, and only the investigations that answer a specific question.
The three-test panel
Lupus anticoagulant, anticardiolipin IgG/IgM and anti-beta-2 glycoprotein I IgG/IgM. Triple positivity carries the highest risk of recurrent thrombosis.
Confirmatory repeat at 12 weeks
A single positive result is not sufficient — antibodies must persist for at least 12 weeks. Infections commonly cause transient positivity and a false diagnosis of a lifelong condition.
Thrombosis confirmation
Doppler ultrasound, CT pulmonary angiography or MRI brain to document the event objectively.
Obstetric history review
Precise timing and number of losses, pre-eclampsia and growth restriction — the pattern of loss is diagnostically important.
Screening for associated lupus
ANA, dsDNA, complement, blood counts and urinalysis, since APS is frequently the first presentation of SLE.
Treatment options
Lifelong anticoagulation after thrombosis
Warfarin with a target INR of 2–3, higher after arterial events. Direct oral anticoagulants are generally avoided in triple-positive APS, where trials showed inferior protection.
Obstetric APS regimen
Low-dose aspirin plus prophylactic low-molecular-weight heparin through pregnancy and the postpartum period — a combination that raises live birth rates from roughly 20% to over 70%.
Hydroxychloroquine
Particularly in lupus-associated APS, with antithrombotic and immunomodulatory benefit.
Aggressive risk factor control
Stopping smoking, avoiding oestrogen-containing contraception, treating hypertension and lipids, and thromboprophylaxis during surgery, immobility or long flights.
Catastrophic APS management
Intensive care with anticoagulation, high-dose steroids, plasma exchange and IVIG — rare but rapidly life-threatening.
Seek urgent medical attention if you have
- Sudden breathlessness or pleuritic chest pain (pulmonary embolism)
- New weakness, facial droop or speech difficulty
- A painful swollen calf
- Reduced fetal movements or a new severe headache in pregnancy
- Rapid multi-organ deterioration — catastrophic APS
Do not wait for a scheduled appointment for any of the above. Call the clinic on +91 70571 19999 or attend the nearest emergency department.
Frequently asked questions about Antiphospholipid Syndrome
I tested positive once. Do I have APS?
Can I have a healthy pregnancy with APS?
Can I take newer blood thinners instead of warfarin?
Get an expert opinion on Antiphospholipid Syndrome in Pune
Consultations at the Ravet clinic in Pimpri-Chinchwad. Bring your previous reports — a properly reviewed history usually saves repeating tests.
Part of a wider group
Autoimmune & Connective Tissue DiseaseMulti-system disease where the complications that matter are silent early.Related conditions
Lupus (SLE)
A multi-system autoimmune disease where early kidney screening changes the entire prognosis.
Vasculitis
Inflammation of blood vessels — where days of delay can cost sight, kidneys or life.
Raynaud's Phenomenon
Usually harmless — but sometimes the first sign of autoimmune disease years in advance.