Q. I am being tested for antiphospholipid syndrome. What will the treatment be?

Answered by
Dr. Smrita Singh
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 28, 2018

Hi doctor,

Following a DVT, my hematologist sent me for a blood test and it needs to be repeated again. According to the test request form, the request is 'antiphospholipid ab blood' and clinical details are 'previous VTEs, lupus ab positive as of October last year'.

I am keen to understand the impact of a second test. If it is positive, what condition would I have and what would the typical treatment be? If it is negative, then am I really safe to stop any treatment? Could the 'positive' condition that arose that may have caused my DVT arise again?

Appreciate your advice.

#

Hello,

Welcome to icliniq.com.

Systemic lupus erythematosus (SLE) is an autoimmune condition. The condition can affect a single organ or multiple organ systems.

DVT (deep vein thrombosis) in SLE is multifactorial. The most common cause is the presence of antiphospholipid antibodies. However, in some patients who are negative for antiphospholipid antibodies, also present with DVT.

Anticoagulant therapy is usually not given on a long-term basis.

If you have antiphospholipid antibodies as per the test results, you need to be worked up for SLE.

For more information consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

Thank you doctor,

I am confused. I was told specifically in person by the hematologist and it was annotated on a letter that I received from my hematologist that I was not being tested for lupus. My understanding is that I am being tested for APS (antiphospholipid syndrome). I am keen to understand why you disagree. Perhaps a second opinion is required?

#

Hello,

Welcome back to icliniq.com.

I understand that you are not being tested for SLE. I provided the information so that you have an idea about the disease.

I said that if you are testing positive for antiphospholipid antibodies, you should get SLE ruled out as APS can be either primary or secondary to SLE or other autoimmune disorder.

For diagnosis, it is mandatory that antiphospholipid antibodies are detected in your blood, on two separate occasions, at least 12 weeks apart. This is the reason your hematologist has asked for the second test for antiphospholipid antibodies. If you test positive on the second occasion for antiphospholipid antibodies, you will be diagnosed with antiphospholipid syndrome. I suggest that in such a case it would be prudent to get tested for SLE or other autoimmune disorders so that if the APS is due to that condition, you can receive appropriate treatment for the autoimmune disorder.

For more information consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

Hello doctor,

Thank you for the answer. That makes sense. Should I have APS, what is the treatment likely to be?

#

Hi,

Welcome back to icliniq.com.

In case you are diagnosed with APS, the treatment is dependent on the individual presentation of the patient. Anticoagulant therapy with heparin is the standard treatment in DVT cases.

For more information consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

Thank you doctor,

I am currently on Eliquis 5 mg twice a day. Are there any particular dangers/concerns I need to be aware of if I were to use long term? What is the advantage of being diagnosed with SLE (if I have no other symptoms) or what is the consequence of having undiagnosed SLE (if I have no other symptoms)?

#

Hi,

Welcome back to icliniq.com.

Eliquis (Apixaban) is a drug that inhibits binding of platelets and prevents clotting, thereby decreasing the risk of DVT in patients who have a predisposition to DVT. Bleeding can be a side effect.

Regarding SLE, it is an autoimmune disorder that can affect multiple organs. Initially, a single organ might be affected but with increased duration, it can affect multiple organs. So, it is actually a disadvantage to have SLE.

If left untreated, it can progress at a faster rate.

For more information consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist


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