Page modified at: 08/10/2010
ANTIPHOSPHOLIPID ANTIBODY SYNDROME
In 1983 Dr Graham Hughes and his team in London described in detail a condition - often known as “sticky blood”, in which there was a danger of thrombosis.
This condition – easily diagnosed by simple blood tests, affects millions of people throughout the world. Once diagnosed the disease can usually be effectively treated the risk of thrombosis (clotting) significantly reduced.
Patients with the syndrome are at risk, both from vein thrombosis (including DVT’s), and in more rarely arterial thrombosis, including a risk of strokes and heart attacks.
In women with the syndrome, the “sticky blood” is unable to get through the sensitive small blood vessels in the placenta to the fetus, and there is a risk of miscarriage and placental insufficiency in later pregnancy which may cause growth restriction and stillbirth. It is now recognised as the main cause of recurrent miscarriage being found in about 20% of such cases.
There are currently three main medications – aspirin, heparin or warfarin. For many thousands of patients, one or two “junior” aspirin a day (approximately 75-150mg) is all that is required. Its main action is to make the platelets of the blood less "sticky" and prevent clotting. It is the main medication used in pregnancy in Hughes Syndrome patients with previous miscarriage.
For those who have actually had a thrombosis, the choice is between heparin and warfarin.
Heparin is a very useful anticoagulant but unfortunately is only available as an injection, and cannot be given long term because of an increased risk of osteoporosis. It is, however, used in some Hughes Syndrome pregnancies, as warfarin is potentially toxic to the developing fetus. One of the common preparations “Clexane” is given as a daily subcutaneous injection at a dose of 20-40mg a day. A blood test (Full Blood Picture) to check the platelet count is usually advised 7-10 days after starting treatment.