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Antiphospholipid Syndrome

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There is no cure for antiphospholipid syndrome (APS). The goals of treatment are to prevent blood clots from forming, resolve those that do, and to minimize tissue and organ damage. Those who have antiphospholipid antibodies but have never had a thrombotic episode or miscarriage are not typically treated. They may never be diagnosed with APS or have associated symptoms or complications.

Individuals with APS should minimize other factors that increase clotting risk, such as smoking and the use of oral contraceptives. If a person has a co-existing autoimmune disorder, then this condition should be managed as well.

Anticoagulants such as warfarin and heparin are typically used to treat existing blood clots. To prevent recurrence, long-term or indefinite anticoagulation with warfarin or an alternative anticoagulant is often necessary. Aspirin may be used if someone has risks for heart attacks.

Women with APS can have successful pregnancies, but they and their fetus must be carefully monitored. Many may be given heparin injections beneath the skin (subcutaneous) and/or low-dose aspirin during pregnancy to help minimize the potential for clotting. Warfarin cannot be used in pregnancy.

For people with "catastrophic" APS, a combination of anticoagulant, glucocorticoid, and plasma exchange treatment with or without intravenous immune globulin is required. Additional treatments may be required to address a low number of platelets (thrombocytopenia) and other APS complications.

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