- recurrent venous/arterial thromboses
- fetal loss
Livedo reticularis may also be a feature.
Antiphospholipid syndrome is associated with:
- lupus anticoagulant - an inhibitor of the coagulation pathway in vitro; pro-coagulant in vivo
- anti cardiolipin antibodies - IgG and IgM
Management is with aspirin post thrombus, or if recurrent thromboses despite aspirin warfarin.
In pregnancy expert advice is needed; in general aspirin is taken once pregnant and LMWH started once the fetal heart is seen. This is continued until 34 weeks. This regime results in 70% success compared with 10% with nothing.
Now for some pictures...