Antiphospholipid Antibody Syndrome
Background
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Antiphospholipid antibody syndrome (APS) = patients who experience thromboses or pregnancy complications and have laboratory evidence of antiphospholipid antibodies in their blood
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Primary APS: the sole manifestation of an autoimmune process
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Secondary APS: in association with another disease such as systemic lupus erythematosus
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The deep veins of the lower extremities are the most common sites of venous thrombosis, and the cerebral vasculature (stroke and TIA) is the most common site for arterial thrombosis
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Multiple body systems may be impacted, including lungs and heart
Considerations
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Patients may be on chronic anticoagulant or antiplatelets agents that may impact perioperative management, including the need for bridging therapy
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Patients are at increased risk of perioperative clotting events and need a DVT prophylaxis plan
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Pulmonary involvement may include pulmonary thromboembolic disease and pulmonary hypertension
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Cardiac involvement may include valvular thickening and valve nodules that may lead to valvular dysfunction
References
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Adriana OD. Hematologic disorders. In: Hines R, Jones S, editors. In: Stoelting's Anesthesia and Co-Existing Disease. 8th Edition. Philadelphia, PA: Elsevier; 2021. p. 465-496.