The Fellow on Call: The Heme/Onc Podcast Episode 134: VTE Series - Diagnosis of Antiphospholipid Antibody Syndrome
Apr 23, 2025
This week, the focus is on antiphospholipid antibody syndrome and its connection to venous thromboembolism. The hosts discuss the complexities of diagnosis, including the significance of specific antibody tests and the common pitfalls of false positives. A real-life case study highlights the clinical criteria necessary for accurate assessment and management. Listeners gain insights into the evolution of the syndrome's understanding and the implications for effective patient care, especially in pregnancy.
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Delay Testing to Avoid False Positives
- Test for antiphospholipid antibodies later rather than inpatient due to many false positives in acute settings.
- Start patients on warfarin immediately if concerned, as they will need anticoagulation anyway.
Nature and Mechanism of APLS
- Antiphospholipid syndrome is an autoimmune disorder causing thrombosis and pregnancy issues with persistent antibody positivity.
- Antibodies promote thrombosis by disrupting normal anticoagulant pathways and increasing prothrombotic cell adhesion molecules.
Prevalence vs Clinical Significance
- Antiphospholipid antibodies are frequently found in the general population but often transient.
- Persistent high titers and clinical correlation are needed to diagnose true syndrome.