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Thrombotic antiphospholipid syndrome: A practical guide to diagnosis and management

Sayar, Z; Moll, R; Isenberg, D; Cohen, H; (2021) Thrombotic antiphospholipid syndrome: A practical guide to diagnosis and management. Thrombosis Research , 198 pp. 213-221. 10.1016/j.thromres.2020.10.010. Green open access

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Abstract

Thrombotic antiphospholipid syndrome (APS) is characterised by venous, arterial and/or small vessel thrombosis in the context of persistently positive antiphospholipid antibodies (aPL). The diagnosis and management of thrombotic APS continues to prove challenging for clinicians. We provide a practical guide to the diagnosis of APS including who to test for aPL and which tests to do. We also consider clinical practice points on the management of venous, arterial and small vessel thrombosis, in the context of first and recurrent thrombotic events. Non-criteria manifestations of APS are reviewed. An approach to recurrent thrombosis and anticoagulant-refractory APS is discussed, with options including increasing the anticoagulation intensity of vitamin K antagonists, switching to low-molecular-weight-heparin, the use of fondaparinux and/or the addition of antiplatelet treatment. Adjunctive options such as vitamin D, hydroxychloroquine and statins are also addressed.

Type: Article
Title: Thrombotic antiphospholipid syndrome: A practical guide to diagnosis and management
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.thromres.2020.10.010
Publisher version: https://doi.org/10.1016/j.thromres.2020.10.010
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Thrombotic antiphospholipid syndrome, Vitamin K antagonists, Direct oral anticoagulants, Recurrent thrombosis, Anticoagulant-refractory, Clinical practice points
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Haematology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: https://discovery.ucl.ac.uk/id/eprint/10136725
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