Last update:

   05-Jul-2004
 

Arch Hellen Med, 20(6), November-December 2003, 633-642

REVIEW

Recent therapeutic developments in the antiphospholipid syndrome

P. AΤΗΑΝΑSSIOU
Department of Rheumatology, “Asclepeion” Hospital, Voula, Athens, Greece

The antiphospholipid syndrome is characterized by thrombosis, recurrent abortions and detection of antiphospholipid antibodies. The management of acute arterial and venous thrombosis is no different from that of thrombosis of other etiology. Thromboprophylaxis can be achieved by long-term administration of oral anticoagulant therapy and warfarin can be used for this purpose. Thrombocytopenia may be managed by corticosteroids and for corticosteroid resistant thrombocytopenia other agents may be used, as well as splenectomy. The management of patients with positive antiphospholipid antibodies who have not suffered an episode of thrombosis consists of long-term follow-up, the removal of other risk factors and the long-term administration of low dose aspirin. Low dose aspirin can be used preconception in women with antiphospholipid antibodies as it may improve placentation. The administration of aspirin and heparin may reduce abortions in women with the antiphospholipid syndrome. In pregnant women with a history of thrombosis heparin should be used for the prevention of thrombosis recurrence, as warfarin can induce fetal damage. Pregnancy in women with the antiphospholipid syndrome should be managed by an expert team approach.

Key words: Αntiphospholipid syndrome, Αspirin, Ηeparin, Recurrent abortions, Thrombosis.


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