ANTICARDIOLIPIN SYNDROME

[TAMY-JO-GODMAN]

    
      Re: ANTICARDIOLIPIN SYNDROME
    


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Posted by ccf Neuro MD on June 17, 1997 at 11:35:06:

In Reply to: ANTICARDIOLIPIN SYNDROME posted by TAMMY JO GOODMAN on June 07, 1997 at 23:20:51:

: CAN SOMEONE PLEASE TELL ME SOME FACTS ABOUT ANTICARDIOLIPIN SYNDROME.  I WAS DIAGNOSED WITH IT IN 1994.
  I HAVE SEVERAL PROBLEMS INCLUDING A MILD HEART ATTACK.  I HAVE HAD TWO MISCARRIAGES AND AM NOW TRYING TO HAVE A CHILD.
  MY HUSBAND AND I HAVE SEVERAL ?'S BUT NOONE WHERE WE LIVE CAN ANSWER THEM FOR US.  I SUFFER FROM SEVERE HEADACHES,
  THAT PUT ME IN BED AND I HAVE THEM FOR WEEKS AT A TIME NOT JUST LITTLE ONE DAY HEADACHES. I HAVE A STABLE HOME LIFE WITH THE NORMAL
  STRESSES.  I WOULD REALLY LIKE IT IF YOU COULD GIVE ME ANY INFORMATION YOU MIGHT BE ABLE TO FIND.
                   THANK YOU,
                    TAMMY JO    
=========================================================================
Hello, Tammy Jo.  Antiphospholipid antibodies area heterogenous group of  antibodies directed against phospholipids, which are essential components of all cells in the body. Cardiolipin is a type of phospholipid that is very commonly involved.  Antiphospholipid antibodies are present  in 2-10% of  the general population and usually don’t cause any symptoms or problems.  In some people, however, these antibodies cause  the blood to clot more readily than normal  ( a hypercoagulable state).  Patients who have symptoms because of this  have “antiophospholipid antibody syndrome” (APAS).  They tend to have higher antibody levels (titers) than people who are asymptomatic.  People with APAS may develop blood clots in the veins, usually in  their legs.  Another common problem is miscarriages. Less often, patients may develop blood clots in their ARTERIES, most commonly of the brain causing strokes.  Some patients with antiphospholipid antibody syndrome have antibodies against the phopholipids on platelets, one of the components of blood, which functions by helping the blood clot.  They can then get a low platelet count and, if the count is very very low,  these patients can develop bleeding problems.
Besides strokes, which can occasionally be seen in patients with APAS, other neurologic symptoms can include migraine headaches.  These headaches are usually throbbing, and associated with nausea or vomiting and sensitivity to light and loud sounds.  These migraines may also be associated with auras (focal neurological symptoms) such as flashing lights, or transient weakness or numbness.  It is difficult for me to say whether your headaches are at all associated with APAS.  
APAS often occurs in people who have other autoimmune diseases such as Rheumatoid arthitis or systemic lupus erythematosis (SLE) and in this instance is termed Secondary APAS.   In fact, 40-50% of  patients with SLE have antiphospholipid antibodies.  (SLE is an autoimmune disorder in which the body produces antibodies to itself.  It can have diverse manifestations including rash, joint pains, kidney disease, seizures.)  If APS is seen in the absence of SLE or other systemic immunologic disorders, it is termed Primary APAS.   Treatment of APAS is somewhat controversial and at this time is  concentrated on medications which thin the blood and make it less likely to clot such as aspirin, heparin and coumadin.  To prevent miscarriages,  patients are sometimes placed on heparin during pregnancy. (coumadin is harmful to the developing fetus).  Heparin needs to be given as a subcutaneous injection, usually twice a day.  
Here is a website address with more information on antiphospholipid antibody syndrome:  http:www.ohsu.edu/clinicweb/handouts/apla.html.  I would recommend that you see an obstetrician with experience with this problem or a hematologist.  If you are interested in coming to the Cleveland Clinic for a second opinion, Dr. Alisa Ross, an obstetrician, and Dr. Bartholomew, a vascular medicine physician with special interest in this area, would be good people to see.
I hope this has been helpful to you.  Good luck.  This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options of your specific medical condition.