Anti-phospholipid antibody syndrome

The anti-phospholipid syndrome (APS) was first described in 1983. The major clinical features consist of arterial (Antiphospholipid Antibodies in Stroke Study [APASS] Group, 1990; Cervera et al., 2002; Nojima et al., 1997; Rosove and Brewer, 1992) and venous (Wahl et al., 1998) thrombosis leading to tissue ischemia and placental thrombosis resulting in recurrent fetal loss (Levy et al., 1998; Rand et al., 1997), and thrombocytopenia in the presence of anti-phospholipid antibodies (Hughes, 1983). The research definition for APS has evolved over the years to its current state including moderate to highly positive anti-cardiolipin and anti-beta-2-glycoprotein 1 (anti-b2GP-I) antibodies present twice at least 12 weeks apart and evidence for a thrombotic event or recurrent fetal loss (Miyakis et al., 2006) (Table 38.1).