Dilemmas in the diagnosis and management of antiphospholipid syndrome.
Case report published in Journal of thrombosis and haemostasis : JTH (2024)
Abstract
Antiphospholipid syndrome (APS) is characterized by thrombosis (which may be venous, arterial, or microvascular) and/or pregnancy morbidity in association with persistently positive antiphospholipid antibodies. Although thrombosis and pregnancy morbidity are the main clinical criteria for a diagnosis of APS in the revised Sapporo (Sydney) criteria, recently published American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria for APS have significantly refined the diagnostic algorithm to include a scoring system clustered into 6 clinical domains (macrovascular venous thromboembolism, macrovascular arterial thrombosis, microvascular thrombosis, obstetric, cardiac valve, and hematologic). Diagnosis of APS is complicated by the fact that significant heterogeneity exists in patients' clinical presentation, underlying vascular risk factors, and methods of detecting antiphospholipid antibodies. Despite the autoimmune nature of APS, anticoagulation remains the main strategy for secondary prevention of thrombosis. Furthermore, optimal antithrombotic treatment in APS patients with arterial thrombosis remains controversial due to a paucity of data from randomized controlled studies. In this paper, we present 2 cases and highlight the diagnostic and therapeutic challenges they pose and how we approach them in the light of current evidence.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Antiphospholipid syndrome (APS) is characterized by thrombosis (which may be venous, arterial, or microvascular) and/or pregnancy morbidity in association with persistently positive antiphospholipid antibodies. Although thrombosis and pregnancy morbidity are the main clinical criteria for a...
Por qué esto importa para la hirudoterapia
Esta revisión con presentaciones de casos examina los desafíos diagnósticos y terapéuticos del síndrome antifosfolípido (SAF), incluyendo la heterogeneidad clínica, las dificultades en la detección de anticuerpos y las controversias en el manejo antitrombótico. Los autores analizan cómo la anticoagulación sigue siendo la estrategia principal para la prevención secundaria de la trombosis en el SAF, mientras que el tratamiento óptimo de la trombosis arterial sigue siendo controvertido debido a los limitados datos de ensayos controlados aleatorizados. El resumen no contiene ninguna mención de sanguijuelas, hirudoterapia, hirudina ni anticoagulantes derivados de sanguijuelas. No existe una conexión defendible con el ámbito de la ASH, ya que el artículo se centra por completo en el manejo farmacéutico convencional y en los criterios de clasificación.
Citación
Dilemmas in the diagnosis and management of antiphospholipid syndrome.
Manning et al. · Journal of thrombosis and haemostasis : JTH, 2024
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: 18 de junio de 2026