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ULY CLINIC
ULY CLINIC
20 Oktoba 2026, 12:37:49
Antiphospholipid syndrome (APS)
20 Oktoba 2026, 12:37:49
Thrombosis (DVT/PE, stroke, MI, small vessels); recurrent miscarriage under 10 weeks, fetal loss, preterm birth; thrombocytopenia; livedo reticularis; valve lesions; APS nephropathy.
Diagnosis (revised Sapporo): one clinical criterion plus lupus anticoagulant, anticardiolipin or anti-β2-glycoprotein I antibodies positive twice at least 12 weeks apart.
Management
No smoking, stay active and hydrated, avoid oestrogen and unprotected immobility or surgery, plan pregnancy.
Situation | Treatment |
Primary prevention (high-risk aPL, SLE without thrombosis, obstetric APS not pregnant) | A: Aspirin 75 mg once daily |
After a thrombotic event (first-line, lifelong) | C: Warfarin 5 mg daily, adjusted to INR 2.0–3.0, with or without aspirin 75–100 mg |
High-risk periods (pregnancy, surgery) | D: LMWH 1 mg/kg SC every 12 hours |
Selected cases (warfarin intolerance or poor INR control) | S: Rivaroxaban 15–20 mg daily (not first-line; avoid in triple positivity) |
Pregnancy | Aspirin 75–100 mg daily AND LMWH 1 mg/kg SC every 12 hours, continued through pregnancy and postpartum; regular fetal ultrasound |