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Antiphospholipid Antibody Syndrome (APS) & Thrombophilia Information

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To visit the official website of the APS Foundation of America, Inc, please click this graphic.

These are various sites that I have collected over the years.   
You can find pictures of my rashes here:
If you find any bad links or duplicates, please notify me so I can correct them.

DISCLAIMER: These webpages are not intended to replace standard doctor-patient visits, physical examination, and medical testing. Information given to you are only an opinions. All information should be confirmed with your personal doctor. Always seek the advice of a trained physician in person before seeking any new treatment regarding your medical diagnosis or condition. Any information received from these webpages are not intended to diagnose, treat, or cure. This site is for informational purposes only.
I am not a doctor or nurse, nor do I pretend to be.  I will not give you medical advice.  I will not engage in the practice of medicine.  I do not copy & paste information and say I wrote it and it was my inspiration or knowledge.  I always cite my sources.  I always support my informtion with credible resources. 
Despite popular belief, I do not get paid for my opinions, stances or links.
I do not recommend any particular treatment/trial for individuals.  It is up to you, as a consumer to find out if these trials posted are something you want to persue. 
I just share the information that I have found.

If you think you may have a medical emergency, call your doctor or 911 immediately.

My Story

I have had a long battle with Seronegative APS (SNAPS).  I was finally diagnosed in 2002.  It is formally documented in my records as Thrombophilia with clinical features of APS.  I also have Thrombophilia secondary to Lipoprotein(a), Livedo and Raynaud’s.

My problems started out in grade school when I developed Fifth Disease.  After that I started having problems with headaches and bloody noses.  In high school, I got the Epstein Barr Virus (EBV) and never have been the same since. I had dizzy (vertigo) spells most of my high school and my first parts of college. My blood pressure would spike during those times.  I would have problems seeing and speaking, my body would twitch and I would have these horrible headaches.  I was told that it was anxiety and that I didn’t want to be in school.  I was an A/B student.  From 1985 to 1992, I really wasn't feeling well at all. I got a reprieve and finished my degree in Public Health Education and started getting active with the US Coast Guard & Auxiliary in hopes of being accepted into Officer Candidate School.  But in 2000 I started having more neurological problems and unfortunately, was forced to stop pursuing the dream of being an Officer in the US Coast Guard.

It started again one summer night in 2002.  I had a TIA (transient ischemic attack) with an amaurosis fugax (temporarily loss of vision in the eye). The ER felt it was a migraine, as I was "too young to have these kinds of problems". They started me on aspirin and I stopped the birth control I was taking.  I sensed there was a bigger problem at play. Two months later I ended up in the hospital with a DVT (Deep Vein Thrombosis).  I was started on Coumadin® and after much trial and error my therapeutic range was set at 3.5-4.5 because I managed to re-clot on Coumadin®.   However, since being placed on Plaquenil®, in 2006, we have been able to reduce my INR to 2.5-3.5.  I still have TIAs despite having a therapeutic INR and being on aspirin and Plaquenil®. 

Getting doctors to listen to me and take me serious has been a battle, especially in the ER. I never got a full clotting panel until I started pushing for answers.  That is when I got one positive test that was “equivocal”.  Because of this, I started a medical symptoms journal to help track my symptoms, my pain, any changes and pain levels.  This has proven to show a progression in my health decline. I also started a photo journal for the times that my face & body has rashes and allergic reactions to the sun, Livedo & Raynaud’s, that my face is drooping but I know by time I get to the ER or call 911 and actually get seen it will be better.

I have shown these pictures to my neurologist who said that yes that is a TIA that is triggering the migraines, specifically verterbrobasliar TIAs. The pictures I had been taking helped save me and get the diagnosis. The neurologist also felt what I was having in high school and college were TIAs, not the panic attacks they thought I was having.  Those pictures have also helped me get on Plaquenil®.  They have helped me get better treatment options from my dermatologist. 

I have the left sided weakness & balance issues, documented by an independent physical therapist, which are consistent with her 80 year stroke patients.  That specific therapy session was actually a good day for me physically, if that says anything. Sadly, the verterbrobasliar TIAs are building up have caused hearing loss and they suspect is causing the increased loss of balance.

I have also had a heart attack. The ER thought it was “acid reflux” and sent me home. After not feeling well for two months, I finally pushed for an answer and they did a perfusion study of my heart.  They found a previous posterior MI (Myocardial Infarction) also known as a heart attack. One and a half years later, the angiogram shows my arteries clear so of course it was “acid reflux” and that perfusion study must have just been wrong. It was ultimately decided that I may have Cardiac Syndrome X. Other than the supraventricular tachycardia, the occasional run of PVCsPACs and mitral valve prolapse that has gotten more pronounced over the years; it is ok.  My kidneys have decided to give me problems but that seems to come and go also but is always blamed on hormones or salt even though I watch my salt intake.

As time has gone on, my Raynauds/Livedo has gotten worse.  My vertigo is coming back, which the neurologist, ENT and GP have decided was a microvascular issue many years ago.  My headaches are getting worse again too.  My guess is that it is connected to the Raynauds/livedo which is also microvascular.  I have problems with cystitis that seems to only come with a flare.   The urologist feels this is due to microvasuclar changes in my bladder from my autoimmune & clotting problems. 

My rheumatologist has decided to diagnosis me with a “touch of Lupus”.  They won’t call it full Lupus because all the sudden don’t have enough symptoms or my blood work is positive but “ok” again.  (It is kind of like being a little bit pregnant.)  I guess you need to have everything happening at once to get a real diagnosis, which I know is not true.

Looking back, I was never really healthy.  I always had some sort of cold, some sort of ear infection, always taking antibiotics or Dimetapp.  I was always tired and just never could keep up with my classmates.  I was always cold and would turn all these funny shades of red, white and purplish/blue.  At the time, we just thought I got frostbite easy.  I never really did ok in the sun.  I got “sun sick” very easy.  Now I wonder how long I really was sick.

I guess all of this is my “new normal”.  I have learned to keep fighting and pushing for answers (though it is really wearing me out) and to keep listening to my intuition; my gut feelings are generally right on.  But in the end, I am told there is nothing more they can do for me, which honestly is quite frustrating.

There are times I think I can get back to normal. But every time, I start getting back to my old "normal" or picking up my pace my INR drops or something else happens.  I just wish I could predict how I will feel later on that week or the next day, etc.  Vertigo & pain are my biggest problems and now these recurring TIAs which appear to be building up.  APS makes it very hard to hold down a paying job and live a normal life so I am now on disability. 

I can no longer do contract work or teach EMS classes because of memory & health issues.  I just go with it day by day do lots of volunteering.

Antiphospholipid Antibody Syndrome (APS) is associated with recurrent clotting events including premature stroke, repeated miscarriages, phlebitis, venous thrombosis and pulmonary thromboembolism. It is also associated with low platelet or blood elements that prevent bleeding. However, even more disease states have been linked with APL including heart attack, migraine headaches, various cardiac valvular abnormalities, skin lesions, diseases that mimic MS, vascular diseases of the eye.


*Tina's Favorite Links


**APS Foundation of America, Inc

Founded in June 2005, the APS Foundation of America, Inc. is dedicated to fostering and facilitating joint efforts in the areas of education, support, research, patient services and public awareness of Antiphospholipid Antibody Syndrome in an effective and ethical manner.  


**APS Friends & Support Forum

A forum run by Heidi & Tina founders of the APS Foundation of America, Inc., a non profit organization. This forum is an information source and a friendly support group for people who have Antiphospholipid Antibody Syndrome or for anyone who's lives are touched by it. It is sometimes referred to as APS, APLS, or APLA and is known as Hughes Syndrome or "Sticky Blood" in the UK. APS is associated with recurrent clotting events including premature stroke, repeated miscarriages, phlebitis, venous thrombosis and pulmonary thromboembolism. If this disease touches your life in some way, please feel free to join in our discussions! :) We're glad to have you visit!  


*APS Foundation of America Brochure

written by the APS Foundation of America, Inc.  


*Medic Alert

HIGHLY recommended! This jewelry could save your life!  


*National Alliance for Thrombosis and Thrombophilia (NATT)

The National Alliance for Thrombosis and Thrombophilia (NATT) is a nationwide, non-profit patient advocacy group representing the interests of people with blood clots and clotting disorders, including people with the APLA syndrome. NATT’s mission is to address major treatment issues, such as preventing thrombosis and its complications, and reducing death and illness related to thrombosis. NATT wants patients to get involved.  


Antiphospholipid Antibodies

Circulation. 2005;112:e39-e44. © 2005 American Heart Association, Inc. Caron P. Misita, PharmD; Stephan Moll, MD  


Antiphospholipid Antibody Syndrome and Pregnancy

Background: Antiphospholipid syndrome (APS) is a recently recognized autoimmune condition that may manifest with fetal loss, thrombosis, or autoimmune thrombocytopenia. Women with these clinical features should be tested for lupus anticoagulant (LAC) and anticardiolipin (aCL) antibodies; most patients with APS have both LAC and aCL immunoglobulin G (IgG) antibodies. The diagnosis of APS requires the presence of both clinical and biological features. Systemic lupus erythematosus (SLE) is a chronic systemic disease with diverse clinical and laboratory manifestations. LAC (and aCL) predisposes to clotting in vivo, predominantly by interfering with the antithrombotic role of phospholipids (PLs); therefore, it is associated with clinical thrombosis, not bleeding. The antiphospholipid (aPL) autoantibodies bind moieties on negatively charged PLs or moieties formed by the interaction of negatively charged PLs with other lipids, PLs, or proteins. aPL antibodies belong to the large family of antibodies that react with negatively charged PLs, including cardiolipin, phosphatidylglycerol, phosphatidylinositol, phosphatidylserine, phosphatidylcholine, and phosphatidic acid. Last Updated: September 4, 2005  


eMedicine - Antiphospholipid Antibody Syndrome : Article by Barry L Myones, MD

Last Updated: October 26, 2004 Promtes an INR in the range of 2.5-3.5.  


eMedicine - Antiphospholipid Syndrome : Article by Steven Carsons, MD

Last Updated: December 5, 2004 Based on the most recent evidence, a reasonable target for the international normalized ratio (INR) is 2.6-3 for a minimum of 6 months for a first thrombosis. Patients with recurrent thrombotic events while well maintained on the above regimen may require an INR of 3-4 and generally receive anticoagulation therapy for life. For severe or refractory cases, a combination of warfarin and aspirin may be used.  


FDA Vitamin K List  


General Management of the Patient with a Positive Antiphospholipid Antibody Test: What Evidence Is Available For You and Your Physician To Consider?

Written by: Gale A McCarty, MD, FACP, FACR You are an individual and your particular case may involve some features that separate you from the study patients. What is most likely to have the right balance of “helpful vs. harmful” effects on you is the major concern of your physician to prevent the effects of aPL antibodies in contributing to blood clots and cell or organ damage in you. Let’s look at the major approaches used to manage your positive aPL test.  



By: Gale McCarty, MD, FACR, FACP. Hydroxychloroquine (HCQ, or its trade name-Plaquenil) has a long and honored history of use in systemic lupus erythematosus (SLE) as a general medication to decrease activity of the immune system and decrease symptoms. For years it has been approved for use by the FDA for lupus and rheumatoid arthritis, and has been used most frequently for skin and joint manifestations. It is considered a mainstay of therapy for any patient with SLE by many lupus experts and rheumatologists. It has many mechanisms of action, some related to decrease in the activity of the immune system, and some related to effects on blood clotting mechanisms. HCQ belongs to the class of drugs call anti-malarials, which includes Chloroquine and Atabrine. (This does not mean that anyone thinks that SLE or APS is caused by the agent that causes malaria-like most discoveries in medicine, it was the chance observation that patients with some autoimmune diseases who got anti-malarial drugs to prevent malaria when traveling to likely areas of infection noted their symptoms improved on HCQ). One of the most complete and excellent reviews of all the literature on the anti-malarials to which all patients and their physicians are directed is Dr. Dan Wallace’s Chapter 59 in the Wallace-Hahn Dubois’ Lupus Erythematosus textbook. Another excellent review on APS therapy in general has been published by Dr. Robert Roubey.  


I Have the Lupus Anticoagulant, But I Don’t Have Lupus?

By: Thomas L. Ortel, MD, PhD “...although the ‘lupus’ anticoagulant was first described in several patients with lupus, most patients with lupus anticoagulants actually don’t have any of the other clinical manifestations of lupus."  


Listen to the Patient — Anticoagulation Is Critical in the Antiphospholipid (Hughes) Syndrome

© 2003. The Journal of Rheumatology Publishing Company Limited. Promotes an INR of greater than 3.0.  


Medical Progress- Antiphospholipid Antibody Syndrome

PDF File from the New England Journal of Medicine  


Migraine, memory loss, and "multiple sclerosis ". Neurological features of the antiphospholipid (Hughes’) syndrome

Postgraduate Medical Journal 2003;79:81-83 © 2003 Fellowship of Postgraduate Medicine. Promotes an INR of greater than 3.0.  


Monitoring Warfarin Therapy in Patients with Lupus Anticoagulants

Recommended therapeutic international normalized ratios (INRs) for oral anticoagulation in patients with lupus anticoagulants who sustain a thromboembolic event are controversial. Patients with lupus anticoagulants often have a prolonged prothrombin time, which may complicate management of anticoagulant therapy.  


New subsets of the antiphospholipid syndrome in 2006: "PRE-APS" (probable APS) and microangiopathic antiphospholipid syndromes ("MAPS").

Autoimmun Rev, December 1, 2006; 6(2): 76-80. The concept of "probable" antiphospholipid syndrome (APS) is almost identical with several conditions which may presage the development of the APS with its major complications of large vessel thromboses resulting in deep vein occlusions in the lower limbs (DVT) particularly and strokes. These conditions comprising livedo reticularis, chorea, thrombocytopenia, fetal loss and valve lesions. These conditions, comprising livedo reticularis, chorea, thrombocytopenia, fetal loss and valve lesions may be followed, often years later by diagnosable APS. The issue whether these patients should be more aggressively treated on presentation in order to prevent the thrombotic complications. A new subset of the APS is proposed viz. microangiopathic antiphospholipid syndrome ("MAPS") comprising those patients presenting with thrombotic microangiopathy and demonstrable antiphospholipid antibodies who may share common although not identical provoking factors (e.g. infections, drugs), clinical manifestations and haematological manifestations (severe thrombocytopenia, hemolytic anaemia) and treatments viz. plasma exchange. Patients without large vessel occlusions may be included in the MAPS subset. These conditions include thrombotic thrombocytopenic purpura (TTP), hemolytic-uremic syndrome (HUS), and the HELLP syndrome. Patients with catastrophic antiphospholipid syndrome (CAPS) who do not demonstrate large vessel occlusions also fall into this group. Disseminated intravascular coagulation (DIC) has also been reported with demonstrable antiphospholipid antibodies and also manifests severe thrombocytopenia and small vessel occlusions. It may cause problems in differential diagnosis.  


Predicting Thrombosis Risk in Individuals with Antiphospholipid Antibodies

Written by: Thomas L Ortel, MD, PhD “...several studies have shown that the presence of a lupus anticoagulant in the blood is associated with a higher risk for a clot than the presence of an anticardiolipin antibody."  


Rare Diseases Clinical Research Network

The Rare Diseases Clinical Research Network was created to facilitate collaboration among experts in many different types of rare diseases. Our goal is to contribute to the research and treatment of rare diseases by working together to identify biomarkers for disease risk, disease severity and activity, and clinical outcome, while also encouraging development of new approaches to diagnosis, prevention, and treatment.  


Rare Thrombotic Diseases Consortium (RTDC)

The Rare Thrombotic Diseases Consortium (RTDC) is an integrated group of academic medical centers, patient support organizations, and clinical research resources dedicated to conducting clinical research in different forms of and improving the care of patients with thrombotic diseases. Funded by the National Institutes of Health (NIH), the RTDC is part of the Rare Diseases Clinical Research Network. The operations of the RTDC are directed from Duke University. Other primary RTDC study sites include the University of North Carolina, University of Wisconsin, Centers for Disease Control and Prevention, and the Mayo Clinic.  


Sapporo Criteria for Diagnosing APLA Syndrome  



By: Gale McCarty, MD, FACR, FACP. “You don’t have the syndrome because your tests are low level or negative…” or “You have livedo, a heart valve problem, and thrombocytopenia, but these aren’t listed as criteria for diagnosis” are comments made frequently by healthcare providers from many specialties to patients with clinical features suggesting the Antiphospholipid Antibody Syndrome (APS).  


Surgical Management of the Primary Dental Patient on Warfarin

Written to inform Dentists about treating Warfarin Patients  


Thrombosis and the Antiphospholipid Syndrome

Hematology 2005 © 2005 The American Society of Hematology. Summary: Even with the most complete datasets, it is still important for the physician to develop a therapeutic plan appropriate for the individual patient, based on clinical presentation, co-morbid conditions, and other variables. With uncommon disorders and limited datasets, such as with the antiphospholipid syndrome, decision-making becomes even more difficult. Table 3 presents a strategy that the author uses when evaluating and developing a treatment plan for a patient with antiphospholipid syndrome and thrombosis, based on the available studies summarized in this article. Critical areas for future research include identifying which patients with antiphospholipid antibodies are at highest risk for thrombotic complications, developing new antithrombotic agents that are effective and safe, and investigating novel approaches to eliminate the autoantibody and, hopefully, the increased prothrombotic state.  


Thrombosis Interest Group of Canada

The Thrombosis Interest Group of Canada consists of a group of 40 specialists in fields related to thrombosis who collaborate to write evidence-based or consensus-based clinical guides on the investigation, management, and diagnosis of thrombotic disorders.  


Warfarin in Antiphospholipid Syndrome — Time to Explore New Horizons

The Journal of Rheumatology Feb. 2005 Promotes an INR greater than 3.0.  


What is “Micro-Clotting”?

By: Thomas L. Ortel, MD, PhD Simply put, micro-clotting, better referred to as “microvascular thrombosis”’ describes blood clotting that is occurring in some of the smallest blood vessels in the body.



General APS Information


*Antiphospholipid Antibody Syndrome

Last Updated: October 26, 2004 Author: Barry L Myones, MD, Director of Research, Pediatric Rheumatology Center, Texas Children's Hospital at Houston; Associate Professor, Departments of Pediatrics & Immunology, Pediatric Rheumatology Section, Baylor College of Medicine Coauthor(s): Deborah McCurdy, MD, Director of Rheumatology, Department of Pediatric Rheumatology, Children's Hospital of Orange County Barry L Myones, MD, is a member of the following medical societies: American Academy of Pediatrics, American Association for the Advancement of Science, American Association of Immunologists, American College of Rheumatology, American Heart Association, American Society for Microbiology, Clinical Immunology Society, and Texas Medical Association Editor(s): Terry Chin, MD, Allergy/Immunology/Pulmonology; Co-Director Cystic Fibrosis and Home Ven, Associate Professor of Pediatrics, Department of Pediatrics, Loma Linda University and Children's Hospital; Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; David D Sherry, MD, Professor of Pediatrics, University of Pennsylvania; Director of Clinical Rheumatology, Division of Rheumatology, Children's Hospital of Philadelphia; Daniel Rauch, MD, Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine; and Norman T Ilowite, MD, Chief, Division of Rheumatology, Schneider Children's Hospital; Professor, Department of Pediatrics, Albert Einstein College of Medicine  


*APS & Surgery Brochure

written by the Hospital for Special Surgery  


*APS & You

written by the APS Foundation of America, Inc. This pamphlet is a layman’s terms summary of Antiphospholipid Syndrome (APS). It covers such topics as diagnosis, symptoms, treatment, and coping. It is meant for patients newly diagnosed, however would also be good for informing friends and family about your disease.  


*APS Information Brochure

written by the Hospital for Special Surgery.  


*Women & APS

written by the APS Foundation of America, Inc.  


A Patients Guide to APS

Doctor Hughes Book on a website  


About thrombosis: thrombophilia: acquired thrombophilia: APS

Another article that supports an INR of 3.0 to 4.0 for APS patients.


American Venous Forum - Patients Section

Founded in 1988, the American Venous Forum provides a serious academic colloquium to physicians interested in the research, education, and clinical investigation in the field of venous diseases. The Forum membership includes more than 225 board-certified vascular surgeons who have an accomplished record of interest and contribution to the management of venous disease. The mission of the American Venous Forum is to improve the care of patients with venous and lymphatic disorders by providing a forum dedicated to education and to the exchange of information concerning basic and clinical research pertaining to the venous and lymphatic systems. In past years, the Forum has dedicated itself to academic pursuits through vigorous educational meetings throughout the country. Today, the Forum is a diverse organization that includes a directory of experienced investigators and clinicians, several of whom can also speak or assist in research on a variety of venous-related topics. The Forum also offers guidelines and protocols for the development of research and clinical trials. With the guidance of the AVF governing officers, the AVF will continue to bring medical professionals and patients the latest venous health information. The AVF By-Laws include more information on our objectives, committees, meetings, and dues.  


Anti-phospholipid antibody syndrome

The Mayo Foundation for Medical Education and Research provides the following web link addressing antiphospholipid syndrome.  


Anticardiolipin Test and the Antiphospholipid (Hughes) Syndrome: 20 Years and Counting!

© 2004. The Journal of Rheumatology Publishing Company Limited.  



by Dr. Ron Ascherson  



(APS) is a term used to describe the association between recurrent clinical events such as thrombosis (arterial or venous), thrombocytopenia, or fetal loss and the presence of a persistent antiphospholipid antibody 1-3. Other clinical conditions associated with the syndrome include stroke, transient ischemic attack, livedo reticularis, migraine, epilepsy, and heart valve disease4. The syndrome is termed "primary" if there is no accompanying autoimmune disease and "secondary" if the patient also has systemic lupus erythematosus (SLE) or an autoimmune disorder1,2,5. Certain infectious diseases and drugs may also result in the formation of antiphospholipid antibodies which do not appear to be associated with clinical complications and do not require therapy1,3,5.  


Antiphospholipid Antibody Syndrome

Indian Pediatrics 2001; 38: 1413-1416 Promotes an INR greater than 3.  


Antiphospholipid Antibody Syndrome

Antiphospholipid syndrome (APS) is characterized by the following: venous or arterial thrombosis--a condition where clots, called thrombi, form in the blood vessels; recurrent miscarriages--the repeated loss of the fetus in pregnancies; and thrombocytopenia--a low number of blood platelets that can lead to bleeding, seen as bruising and tiny red dots on the skin. Medical College of Wisconsin.  


Antiphospholipid Antibody Syndrome

Intelihealth Website  


Antiphospholipid Antibody Syndrome (APS)



Antiphospholipid Antibody Syndromes (APS)

from the Rare Thrombotic Diseases Consortium  


Antiphospholipid or Hughes' syndrome

Supports an INR of 3.0 to 4.0 for APS patients.  


Antiphospholipid Syndrome

*Summary Points Antiphospholipid syndrome is characterized by the presence of venous and/or arterial thrombosis and/or pregnancy morbidity and the presence of antiphospholipid antibodies. Long-term anticoagulation is recommended for antiphospholipid syndrome patients with recurrent vascular events. For antiphospholipid syndrome patients with recurrent pregnancy events, aspirin plus heparin is recommended during pregnacy. Promotes an INR of >3.  


Antiphospholipid Syndrome

Antiphospholipid syndrome (APS) is characterized by the following: venous or arterial thrombosis--a condition where clots, called thrombi, form in the blood vessels; recurrent miscarriages--the repeated loss of the fetus in pregnancies; and thrombocytopenia--a low number of blood platelets that can lead to bleeding, seen as bruising and tiny red dots on the skin.  


Antiphospholipid syndrome

The antiphospholipid syndrome (APS) is characterized by venous and/or arterial thrombosis, recurrent pregnancy loss and the presence of antiphospholipid antibodies. The antiphospholipid antibodies (anticardiolipin, anti-bêta2GPI antibodies, lupus anticoagulant) interacting with various coagulation proteins, platelets or endothelial cells may contribute to disease pathogenesis. Incidence remains unknown, however the reported prevalence of antiphospholipid antibodies in the general population is low (1-4.5%) and increases with age. The main clinical manifestations associated with APS are thromboses, pregnancy morbidity, thrombocytopenia, neurological symptoms, livedo reticularis, hemolytic anemia. The antiphospholipid antibodies have been detected in approximately 1/3 of the patients with systemic lupus erythematosus (SLE). High anticardiolipin antibodies titers, lupus anticoagulant and especially anti-bêta2GPI antibodies are important predictors of APS clinical manifestations in SLE patients. The management of thrombosis includes long-term, high-intensity warfarin therapy [International Normalized Ratio (INR superior or equal to 3)]. For pregnancy morbidity the recommended therapy is low-dose aspirin (80 mg/day) plus subcutaneous unfractionated heparin or low-molecular-weight heparin.  


Antiphospholipid Syndrome

Information provided by the UMHS Hemophilia and Coagulation Disorders Program, February 2003  


Antiphospholipid Syndrome

Copyright © 1996-2005 C. Stephen Foster M.D. All Rights Reserved.  


Antiphospholipid Syndrome

Last Updated: August 10, 2007  





Antiphospholipid Syndrome

Last modified Monday, August 10, 2007  


Antiphospholipid Syndrome

Virtual Medical Centre. Modified: 14/7/2006  


Antiphospholipid syndrome

An. Bras. Dermatol. vol.80 no.3 Rio de Janeiro May/June 2005. Antiphospholipid syndrome is an acquired multisystem disorder characterized by recurrent thromboses in the arterial system, venous system, or both. Antiphospholipid syndrome is classified into 2 groups: primary and secondary. Secondary antiphospholipid syndrome is often associated with systemic lupus erythematosus and less frequently with infections, drugs and other diseases. Serologic markers are antiphospholipid antibodies, lupus anticoagulant and anticardiolipin. The primary diagnostic criteria include arterial thrombosis or venous thrombosis and recurrent fetal loss. About 41% of patients with lupus anticoagulant have skin lesions as the first sign of antiphospholipid syndrome. Cutaneous manifestations include livedo reticularis, cutaneous ulceration and livedo vasculitis. The mainstays of prophylaxis and treatment of thrombosis are anticoagulant and antiplatelet agents.  


Antiphospholipid Syndrome (APS)

Written by: Jan M. Pankey, M.D. Children’s Hospital & Research Center Oakland, California  


Antiphospholipid Syndrome - Making the Diagnosis

SJS - September 2003 Levine JS, Branch DW, Rauch J. The antiphospholipid syndrome. N Engl J Med. 2002;346(10):752-63.  


Antiphospholipid Syndrome from eMedicine

Last Updated: December 5, 2004 Author: Steven Carsons, MD, Chief, Division of Rheumatology, Allergy, and Immunology, Professor of Medicine, Department of Internal Medicine, Winthrop University Hospital, State University of New York at Stony Brook  


Antiphospholipid syndrome: an overview

CMAJ • June 24, 2003; 168 (13) © 2003 Canadian Medical Association or its licensors  


APS Article on Medicine Net

Medical Author: William C. Shiel Jr., MD, FACP, FACR Last Editorial Review: 9/18/2005  


APS Foundation of South Africa

APSSA is a foundation formed to promote much needed awareness of the Antiphospholipid Syndrome (APS) in South Africa.  


Euro-Phospholipid on Line

Official Web-site of the "European Forum on Antiphospholipid Antibodies"  


Hughes' Syndrome

In 1983 and during the following two years, the Lupus Research Unit at St Thomas published a number of papers showing that certain blood proteins (antiphospholipid antibodies) were associated with a syndrome of clotting (thrombosis), recurrent miscarriages and brain disease. Between 1983 and 1985, a comprehensive clinical/laboratory profile was presented showing, for the first time, a wide spectrum of clinical features including the association with artery thrombosis (including major organs such as kidney and liver), brain disease (strokes and other features), skin rashes, low platelet counts, epilepsy and migraine.  


Management of Antiphospholipid Antibody Syndrome

Lim W, Crowther MA, Eikelboom JW. Management of antiphospholipid antibody syndrome. A systematic review. JAMA 2006; 295:1050–1057  


Managing antiphospholipid syndrome

Copyright Springhouse Corporation Mar 2004  


Medical Progress- Antiphospholipid Antibody Syndrome

PDF File from the New England Journal of Medicine  


New Treatments For Lupus Anticoagulants  


NORD - National Organization for Rare Disorders, Inc.

Copyright 1994, 1995, 1996, 2001, 2002  


Official Web-site of the "European Forum on Antiphospholipid Antibodies"  


Old-fashioned detective work

August 20, 2005  


Pathogenesis of the Antiphospholipid Syndrome  



This page is in Italian.  


The "primary" antiphospholipid syndrome: major clinical and serological features.

Medicine (Baltimore). 1989 Nov;68(6):366-74.  


The Antiphospholipid Story

© 2003. The Journal of Rheumatology Publishing Company Limited.  


The Antiphospholipid Syndrome

Most patients with venous or arterial thrombosis and APS do well with conventional warfarin treatment (target INR 2.0 - 3.0). It is recommended that patients with recurrent thrombosis despite conventional doses of warfarin should maintain an INR of 3.0 - 4.0. This recommendation is based on one descriptive study and requires confirmation by randomised trials. The benefit of adding aspirin in arterial disease is not clear, and is likely to increase the risk of bleeding.  


The antiphospholipid syndrome (Hughes' syndrome)

Last updated 01.08.2005 Written by Dr MY Karim, lecturer in immunology, St Thomas' Hospital and Dr GRV Hughes, consultant physician and rheumatologist, St Thomas' Hospital  


The antiphospholipid syndrome.

Natl Med J India. 2003 Nov-Dec;16(6):311-6. Promotes an INR of 3-4.  


The expanding spectrum of renal diseases associated with antiphospholipid syndrome.

Am J Kidney Dis. 2003 Jun;41(6):1205-11. The cases reported here represent a new aspect of the expanding spectrum of renal diseases encountered in association with APS.  


The Spectrum of the Antiphospholipid Syndrome: A Matter of Perspective

© 2001. The Journal of Rheumatology Publishing Company Limited.  


Unusual Manifestations of the Antiphospholipid Syndrome

Reported by Ronald A. AshersonI MD,FACP,MD(Hon)FRCP,FCP(SA)FACR,and Ricard Cervera2 MD,PhD  


Warfarin in Antiphospholipid Syndrome — Time to Explore New Horizons

The Journal of Rheumatology Feb. 2005  


What You Need to Know About Antiphospholipid Syndrome

Robert G. Lahita, MD, PhD WOMEN’S HEALTH in Primary Care 318 Vol. 5, No. 5/MAY 2002



APS & MS or is it APS vs. MS??


Here are a few articles for those of you who aren't really sure if you have APS or MS.  I will let you decide.  If you doubt your diagnosis after reading these articles please get tested. 


I was told I had MS - but the doctors were wrong


APS and MS


I was told I had MS - but the doctors were wrong


Cardio-Pulmonary Issues Related to APS

eMedicine - Libman-Sacks Endocarditis: Article by Elizabeth W Ryan, MBBS


Regurgitation articles, support groups, and resources / Other Types of Angina


WebMD - Mitral Valve Prolapse (MVP)


Pregnancy Information

ADVANCE for Nurse Practitioners | Antiphospholipid Antibody Syndrome & Pregnancy Loss: Management In Primary Care Settings  


Antiphospholipid antibodies and pregnancy loss  


Antiphospholipid antibodies and pregnancy rates and outcome in in vitro fertilization patients  


Antiphospholipid antibodies and pregnancy rates and outcome in in vitro fertilization patients

Authors: A. Denis, M. Guido, R. Adler, P. Bergh, C. Brenner, R. Scott, Jr. Source: Fertility and Sterility: June, 1997 (Vol. 67) Pages 1084-1090.  


Antiphospholipid Antibody Syndrome (Lupus-Like Syndrome) and Pregnancy

By Denise Chism, R.N., M.S.N., P.N.N.P. WebMD Medical Reference from "The High-Risk Pregnancy Sourcebook"  


Antiphospholipid Syndrome (aPL) High Risk Pregnancy

Antiphospholipid syndrome is an autoimmune disease in which the body produces large amounts of antiphospholipid antibodies. Phospholipids are a special type of fat containing phosphate that makes up the outer walls of the body's cells. Antiphospholipid antibodies attack the phospholipids. This causes many different problems including increased blood clotting. Cardiolipin is one type of phospholipid and specific anticardiolipin antibodies may develop.  


Child Health Library - High-Risk Pregnancy - Antiphospholipid Syndrome (aPL)  


eMedicine - Antiphospholipid Antibody Syndrome and Pregnancy  


Obstetric Implications of Antiphospholipid Antibodies: Pregnancy Loss and Other Complications

Clinical Obstetrics and Gynecology: Volume 44(1) March 2001 pp 2-10  


Pregnancy: Keeping Yourself and Your Baby Healthy

Please note: This information was as current as we could make it on the date given above. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit, the AAFP patient education Web site.  


Recurrent Pregnancy Loss: Management



Lupus Related Information

WebMD - Lupus (Systemic Lupus Erythematosus)


eMedicine - Systemic Lupus Erythematosus: Article by Julie Hildebrand, MD


Lupus Foundation of America, Inc.


Lupus: Support and Survival


Laboratory Tests Used in the Diagnosis of Lupus - Lupus Foundation of America, Inc.


eMedicine - Systemic Lupus Erythematosus: Article by David W Lamont, DO


Lupus Information - General

American College of Rheumatology  


Care of the Lupus Patient

By NIAMS. WebMD Public Information from the National Institutes of Health  


Caring for patients with systemic lupus erythematosus

Nursing, Nov 1995 by Ferrante, Christine, Derivan, Mary Collins  


Christine Ostwinkle Foundation for Lupus

The Christine Ostwinkle Foundation for Lupus is dedicated to helping families win their fight against Lupus, providing information and statistics regarding Lupus, and assisting researchers in finding a cure.  


Dorough Lupus Foundation

The Dorough Lupus Foundation is an independent, non-profit organization. The Foundation's goals are to aide in research and educate the public about Lupus.  


Faces of Lupus

Notice NOT all of these faces have a very prominent rash or a rash at all.  


Frequently Asked Questions About Lupus

December 3, 2004  


Laboratory Tests Used to Diagnose and Evaluate SLE

The National Institute of Arthritis and Musculoskeletal and Skin Diseases of The National Institutes of Health. Laboratory Tests Used to Diagnose and Evaluate SLE. Last revised, January 26, 1999.  


Living with Lupus

Nation's Business, March, 1993 by Marcia J. Pear  



Written by: Rosalind Ramsey-Goldman, MD, DrPH - Northwestern University, Chicago, IL Published on: June 24, 2001 Editorial Review: October 14, 2004  



The following is a transcript of a talk Dr. Petri gave at the British Columbia Lupus Society Symposium in November, 2002.  


Lupus (SLE) Patient Booklet

This booklet is written for people with lupus and their families and friends. It explains how lupus develops, how it affects different parts of the body, how it can affect people in different ways, and how doctors diagnose it. We then explain how it can be treated and offer tips and advice on living with it more easily. Near the end of the booklet you will find information on how to contact the Arthritis Research Campaign (arc), and a few suggestions for further reading. We have also included a glossary of medical words (like cartilage). We have put these in italics when they are first used in the booklet.  


Lupus erythematosus in children: A report of six cases

Samy Fenniche MD, Sana Triki MD, Rym Benmously MD, Hayet Marrak, MD Feiza Ben Ammar MD, Insaf Mokhtar MD Dermatology Online Journal 11 (2): 11 Dermatology Department, Habib Thameur Hospital, Tunis.  


Lupus Foundation of America

With nearly 300 chapters, branches and support groups in 32 states, the Lupus Foundation of America (LFA) is the nation's leading non-profit voluntary health organization dedicated to finding the causes and cure for lupus. Our mission is to improve the diagnosis and treatment of lupus, support individuals and families affected by the disease, increase awareness of lupus among health professionals and the public, and find the causes and cure. Research, education, and patient services are at the heart of LFA's programs.  


Lupus Health Center

Nine out of ten people who have lupus are women. Get in-depth information on lupus, its causes, symptoms, and treatments. Plus, find daily help in our online support group.  


Lupus Italy

This page is in Italian.  


Lupus Research Institute Rewrites the Headlines on Heart Disease  


Lupus Site (SLE)- Lupus Symptoms  


Lupus: A Patient Care Guide for Nurses and Other Health Professionals Revised September 2006. Lupus: A Patient Care Guide for Nurses and Other Health Professionals is intended to provide an overview of lupus and how to care for patients who have the disease. It is not intended to provide medical guidelines for diagnosing and treating lupus, nor is it intended to be all-inclusive. Specific medical advice is not provided, and NIAMS urges readers to consult with a qualified physician for diagnosis and for answers to individual questions.  


Lupus: Living With The Wolf

Published/Last Reviewed on: October 16, 2004  


S.L.E. Lupus Foundation

Founded in 1970, the Foundation helps people with lupus, as well as their families and friends, cope with the anxieties and frustrations that often accompany daily living with a chronic illness. Sharing information and networking among patients and their families further helps dispel myths and provides daily support to those learning to live with lupus. We invite you to take full advantage of our comprehensive resources.  


St. Thomas' Lupus Trust

The official website of the St. Thomas' Lupus Trust and Dr. Graham Hughes. This website contains information for medical professionals, patients and supporters.  


Systemic Lupus And The Nervous System

Although nervous system involvement in systemic lupus erythematosus (SLE) is unclear and controversial, people with lupus do often experience signs associated with the body's nervous system, such as: headaches, confusion, difficulty with concentration, fatigue, occasional seizures or strokes.  



Updated May 2004 Written by Ellen Ginzler, MD, and Jean Tayar, MD, and reviewed by the American College of Rheumatology Communications and Marketing Committee.  


Systemic Lupus Erythematosus

© 2000, Family Practice Notebook, LLC . These pages are best viewed with Microsoft Internet Explorer 5.0 or greater for full functionality. This is one page of 12 in this chapter, 140 in this book, and 4645 in the Family Practice Notebook.  


Systemic Lupus Erythematosus

Adapted with permission from Madhok R, Wu O. Systemic lupus erythematosus. Clin Evid Handbook June 2007:368-70.  


Systemic Lupus Erythematosus and Sjogren Syndrome

Posted 11/25/2002 Michael D. Lockshin, MD; Jane E. Salmon, MD Registration Required.  


Systemic lupus erythematosus: Unmasking a great imitator

Nursing2005, November 2005  


The DRM WebWatcher Lupus  


Treatment of Systemic Lupus Erythematosus: An Update

This article suggests an INR of 3 to 4 for patients with APS. Dr. Petri is one of the leading APS specialists and this webpage would be good to show your doctor if you are having a problem getting him/her to take you seriously that our INRs need to be higher. American Family Physician® > Vol. 57/No. 11 (June, 1998)  


We Have Lupus  


What can you say about systemic lupus erythematosus?

Copyright Springhouse Corporation Aug 2004  


What is Systemic Lupus Erythematosus?

Published: Mar/Apr 2005  


What the Lupus Butterfly Looks Like


Coumadin and Other Drug Information

When on Coumadin you must watch your Vitamin K intake or at least be very consistent with it. 


Welcome to

Labor of love by a clinical pharmacologist in CO; detailed site regarding warfarin.


Warafarin vs. Coumadin. 


WebMD – Lovenox


WebMD – Fragmin


















There are many more drugs that are commonly used in APS patients. 


Medication Information

Anticoagulant Therapy Monitoring Guidelines  


Anticoagulants (Systemic)

Revised: 08/23/1994  


Birth control options in thrombophilia


While progestin-only contraceptives do not increase the risk of thrombosis in the general population, it is not known whether they may increase the risk for thrombosis in people who (a) have had a previous clot or (b) have factor V Leiden or another thrombophilia. In the absence of data I think it is fair to conclude that one can not rule out a small increased risk of thrombosis with progestin-only contraceptives. The concern about a potential thrombophilic risk of progestin-only contraceptives stems from the fact that progestins used at higher doses for other purposes than contraception (dysfunctional uterine bleeding, amenorrhea) may be associated with an increased risk of thrombosis. This is a scientific field that is evolving and hopefully at some point in the future we will have data as to whether progestin-only contraceptives increase the risk for thrombosis in thrombosis-prone individuals or not. Progestin-only contraceptives are: Oral pills Micronor®, Ovrette®, NOR-QD®. Depo-Provera (= depot medroxy-progesterone) Mircette® IUD  



Copyright 1996-2003 Cerner Multum, Inc. Version: 8.01. Revision date: 5/13/03.  




Drug Interactions with Coumadin

Although access to this page is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians. © 2000, Family Practice Notebook, LLC . These pages are best viewed with Microsoft Internet Explorer 5.0 or greater for full functionality.  


Heparin (Systemic)

Revised: 08/23/1994  


Low-Molecular-Weight Heparins in Pregnancy


Pharmacotherapy 19(9):1013-1025, 1999. © 1999 Pharmacotherapy Publications  


Of Blood, Bones, and Broccoli: Warfarin Vitamin K Interactions

Home Healthcare Nurse. March 2004. Volume 22-Number 3-Pages 178 - 182  

Plasmapheresis, immunosuppression, antibiotics can treat antiphospholipid crisis

Anticoagulation Complications-August 18, 2003  


Rituxan for Treatment of Idopathic Factor VIII Inhibitors

June 2003 Power Point Presentation  


Should I be taking heparin?  


Thrombolytic Agents (Systemic)

Revised: 12/17/2003  



Last Revised - 04/01/2003  


Warfarin Drug Interaction List

It is by generic name. If you do not know the generic name there is a list by US brand names (and a few for other countries) accessed by a link at the bottom of the page. If you do not know either the generic name or the US brand name, there is a google search link at the bottom of the page. Type in the brand name for your country and you should be able to find something telling you the generic name. The journal references are on the pages. Where there are no journal references, it is noted that this is his observation only. Remember smaller the sample (if it only happened to one person) the less likely it is to be applicable to others.  


Warfarin Therapy: Evolving Strategies in Anticoagulation

Published in the American Family Physician, Feb. 1999. A good general article, promotes an INR of 3-4 for APS patients.  


What are anticoagulants?


Can't Afford Your Prescriptions??


Free Medicine Foundation

Need help paying for your medicine? Help is here for you. Established by volunteers, Free Medicine Foundation has helped countless families across the nation completely eliminate or substantially reduce their prescription drug bills.  


Free Meds and Solutions

Our Focus at Free Meds and Solutions is to provide you and your loved ones with programs that will save or eliminate prescription medicine costs ,as well as a number of associated assistance programs. Our site is designed to assist you in accessing the 100’s of Patient Assistant Programs. We provide the most up-to-date information, qualifying criteria, applications and detailed instructions for these programs. We are available via email or our toll-free number with quick responses to any question that you or your Physician may have.  


How to Spot a "Quacky" Web Site

The best way to avoid being quacked is to reject quackery's promoters. Each item listed below signifies that a Web site is not a trustworthy information source. The hyperlinks will take you to articles on Quackwatch that explain why. The same criteria can be used to identify untrustworthy books, talk-show guests, etc. This page was revised on September 6, 2006  



Developed by Governor Blagojevich, I-SaveRx is available and open to all Illinois, Wisconsin, Kansas, Missouri and Vermont residents. The I-SaveRx program offers a safe, simple and affordable way to purchase the medication refills you need - at savings of up to 80%!  


Lovenox Reimbursement Services & Patient Assistance Program

Eligibility: This program is designed to identify if the patient is eligible for Lovenox through private insurance coverage, individual medication programs, and or government-funded sources. Aventis will provide Lovenox free of charge under the following qualifications. Participants must be U.S. residents, their annual household income must fall below the Aventis Poverty Guidelines, and they must have no insurance coverage for Lovenox. This program is available for outpatients only. Please also see:

This site is designed to provide information about patient assistance programs which provide no cost prescription medications to eligible participants.  


Partnership for Prescription Assistance

The Partnership for Prescription Assistance brings together America’s pharmaceutical companies, doctors, other health care providers, patient advocacy organizations and community groups to help qualifying patients who lack prescription coverage get the medicines they need through the public or private program that’s right for them. Many will get them free or nearly free. Its mission is to increase awareness of patient assistance programs and boost enrollment of those who are eligible. Through this site, the Partnership for Prescription Assistance offers a single point of access to more than 275 public and private patient assistance programs, including more than 150 programs offered by pharmaceutical companies. To access the Partnership for Prescription Assistance by phone, you can call toll-free, 1-888-4PPA-NOW (1-888-477-2669).  


Patient Advocate Foundation's Co-Pay Relief (CPR) Program

Patient Advocate Foundation's Co-Pay Relief (CPR) Program provides direct co-payment assistance for pharmaceutical products to insured Americans who financially and medically qualify. We are pleased to announce that beginning on January 1, 2006 CPR will begin welcoming new Medicare Part D beneficiaries who require assistance with their pharmaceutical co-payments. The Program offers personal service to all patients through the use of CPR call counselors; personally guiding patients through the simple enrollment process.  


Patient Services Incorporated

PSI is committed to assisting persons with chronic medical illnesses in accessing health insurance and pharmacy co-payment assistance. Developed in 1989, PSI is a non-profit charitable organization, primarily dedicated to subsidizing the high cost of health insurance premiums and pharmacy co-payments for persons with specific chronic illnesses and rare disorders. Families requiring assistance in maintaining the high cost of their health insurance premiums or co-payments are offered assistance based upon the severity of medical and financial need. PSI offers a "safety net" for persons who have expensive chronic illnesses and for those persons who "fall through the financial assistance cracks".  


Prescription Drug Resource Center - Order Drugs from Canada  

Prescription Drug Resource Center - Other Resources  


Rx Outreach

Rx Outreach is an easy and affordable way for people of all ages to get medicines they need. Through this program, people who qualify financially can get more than 55 generic medications that treat a wide range of conditions including diabetes, asthma, heart disease, and depression. People may take advantage of the program even if they receive medicines through another discount program. The program is available to individuals and families with incomes of up to 250 percent of the federal poverty level. For a family of four, this figure is about $48,000 per year.  



RxAssist, created by Volunteers in Health Care, provides physicians and other health care providers with the information you need to access the pharmaceutical companies’ patient assistance programs.

RxHope is the only patient assistance Internet initiative financially supported by PhRMA (Pharmaceutical and Research Manufacturers of America) and participating pharmaceutical companies. RxHope began as a grassroots effort of the Patient Assistance Managers and Directors of the PhRMA-member companies and has grown into the leading Internet-based patient assistance and sampling web portal in the pharmaceutical industry. Each patient assistance request form has been custom-designed to the pharmaceutical company's rules engine. RXHope removes the time and costs of these programs by web-enabling labor-intensive paperwork onto the physician's computer. RxHope is an independent company, and is not affiliated with third parties who may provide patients with no-cost or low-cost medications. Those third parties do not endorse the content or processes used on this website, including our information collection or data storage processes.  


Saving on Prescriptions  


The Medicine

Disclaimer: This program is not a prescription insurance policy. This program provides discounts at certain participating pharmacies for services. This plan does not make payments directly to the providers of health services. Program members are obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with the discount plan organization.



Thrombosis Information

A New Perspective On DVT

Deep vein thrombosis (DVT) is a blood clot in a vein. This condition can affect men or women of any age, race, or social status. DVT is a potentially serious condition. Fortunately, advances in technology have made it easier and virtually painless to confirm that you have DVT.  



Mark H. Meissner, MD, and E. Eugene Strandness, Jr., MD  


American College of Medical Genetics Consensus Statement on Factor V Leiden Mutation Testing

Wayne W. Grody, MD, PhD1, John H. Griffin, PhD2, Annette K. Taylor, MS, PhD3, Bruce R. Korf, MD, PhD4, and John A. Heit, MD5 (ACMG Factor V Leiden Working Group) © 2001-2005 American College of Medical Genetics. All rights reserved  


Antithrombin III Deficiency

Antithrombin-III deficiency can cause or lead to thrombosis, a clot forming in a blood vessel. If a clot attached to a blood vessel wall breaks loose and travels in the bloodstream, it is called an embolus. An embolus that reaches a blood vessel in the lungs is called a pulmonary embolism. This type of clot can block the blood vessel, cut off the oxygen supply to the lung tissue, and, in some cases, cause death. Article Reviewed: 1999-03-17  


Blood Clotting  


Central Retinal Vein Occlusion

Management of Central Retinal Vein Occlusion  


Cerebrovascular Diseases, Stroke - Internet Handbook of Neurology

A Collection of High Quality Online Resources for Health Professionals  


Circulation -- Hirsh and Hoak 93 (12): 2212 Management of Deep Vein Thrombosis and Pulmonary Embolism  


Clot-Busting Stroke Drug's Benefit Reaffirmed  


Coping After a Stroke -- Full-Length Doctor's Interview  


Deep vein thrombosis

Published by BUPA's Health Information Team June 2003  


Deep Venous Thrombosis and Thrombophlebitis

Last Updated: March 2, 2005  


Diagnosis of pulmonary embolism

CMAJ • January 21, 2003; 168 (2) © 2003 Canadian Medical Association or its licensors  


Diagnostic tool may prevent heart attack, stroke before they happen   Excess Factor VIII: A Common Cause of Hypercoagulability

Conclusions: Factor VIII assay should be considered in the work-up of idiopathic, recurrent VTE. Long-term anticoagulation may be appropriate in this setting.  


Factor V Leiden - Cardiology Patient Page

(Circulation. 2003;107:e94.) © 2003 American Heart Association, Inc. You may have been tested for the condition known as factor V Leiden (pronounced factor five lye/-den) because you or someone in your family has had a blood clot in one of the deep veins of the body (also called deep vein thrombosis, or DVT) or a blood clot that traveled to the lung (also called a pulmonary embolism, or PE). Thrombophilia is the term used to describe the propensity of some people to form abnormal blood clots, and it may be either a condition that developed during your lifetime or that you inherited through your family. Some examples of situations in which thrombophilia develops include cancer, diabetes, obesity, and surgery. This Cardiology Patient Page will concentrate on factor V Leiden, the most common cause of inherited thrombophilia.  


Factor V Leiden and Antiphospholipid Antibodies Are Significant Risk Factors for Ischemic Stroke in Children

(Stroke. 2000;31:1283.) © 2000 American Heart Association, Inc.  



Fibrinogen is a protein that plays a key role in blood clotting. Fibrinogen is a sticky, fibrous coagulant in the blood that appears to significantly increase the risk of experiencing one of the leading causes of death and disability - stroke.  


Genetics of thrombophilia

Last Updated: 2/15/2004  


Homocyst(e)ine, Diet, and Cardiovascular Diseases


(Circulation. 1999;99:178-182.) © 1999 American Heart Association, Inc.  


Homocysteine and MTHFR Mutations - Cardiology Patient Page

(Circulation. 2005;111:e289-e293.) © 2005 American Heart Association, Inc.  

Homocysteine and MTHFR Mutations: Relation to Thrombosis and Coronary Artery Disease

(Circulation. 2005;111:e289-e293.) © 2005 American Heart Association, Inc. Elizabeth A. Varga, MS; Amy C. Sturm, MS; Caron P. Misita, PharmD; Stephan Moll, MD  

Hypercoaguablity States

Hypercoagulable states can be defined as a group of inherited or acquired conditions that are associated with a predisposition to venous thrombosis (including upper- and lower-extremity deep venous thrombosis with or without pulmonary embolism, cerebral vein thrombosis, and intra-abdominal venous thromboses); arterial thrombosis (including myocardial infarction, stroke, acute limb ischemia, and splanchnic ischemia); or both. Venous thromboembolic disease is the most common clinical manifestation resulting from hypercoagulable states. Although most inherited conditions appear to increase solely the risk of venous thromboembolic events (VTEs), some of the acquired conditions have been associated with both VTEs and arterial thrombosis. These include cancer, myeloproliferative syndromes, antiphospholipid antibodies (APA), hyperhomocysteinemia, and heparin-induced thrombocytopenia. Reviewed December 15, 2003  


Hypercoagulability: Too Many Tests, Too Much Conflicting Data

Hematology 2002 © 2002 The American Society of Hematology  


Hyperhomocysteinemia, Pregnancy Complications, and the Timing of Investigation

Obstetrics & Gynecology 2004;104:336-343 © 2004 by The American College of Obstetricians and Gynecologists  


Long-Term, Low Intensity Warfarin Therapy for the Prevention of Recurrent Venous Thromboembolism

You have to pay to view the full article. APS patients were not included in this study. However, this particular article I do have in full. Please email me at:  


Management of Venous Thromboembolism

23 Feb, 2003 Venous thrombosis is the third most common cardiovascular disease after ischemic heart disease and stroke.1 It is common in whites, affecting 1 in 1,000 individuals every year, and is strongly associated with life-threatening pulmonary embolism (PE). Though the exact incidence is not known in India it is becoming a common clinical problem because the physicians and the surgeons are now more aware of venous thrombosis. In addition to circumstantial predisposing factors, pregnancy, or immobilization), genetic abnormalities, molecular abnormalities of components of the coagulation pathway leading to hypercoagulability and, in turn, to thrombophilia have been found in subjects who have had thromboembolic disease.  


MRI may help identify an impending STROKE or HEART ATTACK.  

Post-Thrombotic Syndrome

Post-thrombotic syndrome is the name used to describe the long-term effects that can occur after you have had a venous thrombosis of the deep veins of the leg. It is caused by damage to the veins, resulting in higher than normal blood pressure. This increased pressure on the vein walls can damage the valves, which normally work to keep blood flowing properly through your veins. Poor blood flow can lead to pain, swelling and leg ulcers, which are some of the symptoms of post-thrombotic syndrome. Post-thrombotic syndrome can cause serious long-term ill health, poor quality of life, and increased costs for the patient and the healthcare system. Last modified: 19-Dec-2003  


Prevention of Deep Vein Thrombosis and Pulmonary Embolism - Cardiology Patient Page

(Circulation. 2004;110:e445-e447.) © 2004 American Heart Association, Inc.


Prothrombin 20210

Prothrombin is one of the blood clotting factors. It circulates in the blood and when activated, is converted to thrombin. Thrombin causes fibrinogen, another clotting factor, to convert to fibrin strands, which make up part of a clot.  


Pulmonary Embolism and Deep Vein Thrombosis - Cardiology Patient Page

(Circulation. 2002;106:1436.) © 2002 American Heart Association, Inc.  


Pulmonary Embolism: JAMA Patient Page

(JAMA. 2001; 285:836) Published in JAMA: February 14, 2001   


Self-attacking antibodies up stroke risk in women  


Teaming up with a STATIN to prevent HEART ATTACK and STROKE  


The facts on post-thrombotic syndrome

Venous thrombosis is the development of a blood clot in a vein. Sometimes, thrombosis leads to serious short-term and long-term effects. A possible short-term effect is pulmonary embolism, in which the blood clot breaks into pieces, travels to the lungs and blocks the flow of blood through the lungs. Long-term effects are known as post-thrombotic syndrome. If you have had a venous thrombosis, you may be at risk of developing post-thrombotic syndrome.  


Thromboembolism: Low-Molecular-Weight Heparin Safe for Pregnant Women, October 5-12, 2000  


Thrombophlebitis: Blood Clots in Your Legs

Click on search and type in Antiphospholipid Antibody Syndrome. There will be 400+ hits. Most of them are related to Lupus. It just shows how closely APS and Lupus are related.  

What is a stroke? What is a TIA?

Please note: This information was as current as we could make it on the date given above. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit, the AAFP patient education Web site. Copyright © 2004 by the American Academy of Family Physicians  


What you need to know about Hypercoagulable States (blood clotting disorders)

When you cut or injure yourself, your body stops the bleeding by forming a blood clot. Proteins and particles in your blood, called platelets, stick together to form the blood clot. The process of forming a clot is called coagulation. Normal coagulation is important during an injury, as it helps stop a cut from bleeding and starts the healing process. However, the blood shouldn't clot when it's just moving through the body. If blood tends to clot too much, it is called hypercoagulation or a hypercoagulable state (also called thromboembolic state or thrombophilia).


Other Links

5 Emergencies: Do You Know What to Do?

It is a really good idea for you, your family and friends to take a First Aid & CPR Course.  


Autoantibody-mediated atherosclerosis.  


Dyslipidemias and autoimmune diseases  


Endothelial dysfunction linked with early signs of atherosclerosis in young adults  


Hospital Stockings Cut Problems From Leg Clot

It is a very good idea to own a set of these stockings. I wear them when I am driving or flying for long periods of times.  


Hot Summer Days Can Make Sick People Sicker

Very Good Reminder. States that Lupus and MS patients are more at risk for heat related problems.  


Immune cells may contribute to plaque buildup in arteries  


Intermittent Pneumatic Compression of the Foot and Calf May Help in Arterial Claudication  


Life-Saving Checklist

Sadly, I was almost one of these stats recently. Always make sure you know what they are putting in your IV!!!  


Lipoprotein (a): its role in childhood thromboembolism.  


Lipoprotein(a) oxidation and autoantibodies: a new path in atherothrombosis. 


New test may diagnose causes of women's chest pain  


On-line Archives of Rheumatology

The On-line Archives of Rheumatology publishes original papers dealing with the clinical manifestations, laboratory investigations and the treatment of rheumatic diseases.  


Questions and Answers about Raynaud's Phenomenon

The NIAMS gratefully acknowledges the assistance of Paul Plotz, M.D., NIAMS, NIH; Phillip J. Clements, M.D., of the University of California, Los Angeles; Jay D. Coffman, M.D., of the Boston University Medical Center; and Frederick M. Wigley, M.D., of The Johns Hopkins University School of Medicine in the preparation and review of this booklet.


Treatment of Vertigo

Treatment of Vertigo - March 15, 2005 - American Family Physician  


Vascular Spasm Cause of Heart Muscle Damage

I have problems with this. I was always told it was in my head. Too bad the heart damage showed up on my perfusion study. :o( Nitro will help this chest pain. I am guessing this would be linked with Cardiac Syndrome X.  




Vertigo-A Type of Dizziness  



Peripheral Artery Disease & Intermittent Claudication. ASPers have problems with this. A vasodialator such as Nitrogylcerin or Imdur may help this.  


Click Here to purchase APS Gear on Cafe Press!


Click here to go to the Official Support Forum of the APS Foundation of America, Inc.

For more APS & Thrombophilia information, please click this graphic.  

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Antiphospholipid Antibody Syndrome (APS) & Thrombophilia Information by Christina M. Pohlman is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.


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Do you send flowers to family or friends? The APSFA has partnered with and they have made us our own special online flower shop website! We have BEAUTIFUL arrangements for ALL occasions for EXCELLENT prices! Click the graphic below to see our site!  Bonus: 12 % of the proceeds goes to the APSFA!


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Want to help me and the hundreds of thousands other people with this disease?  Use this search engine, powered by Yahoo, and enter in APS Foundation of America - APSFA.  Even better, set it to your homepage.  Thanks!

The Antiphospholipid Story