Last reviewed: November 2017
Last updated: October  2017

Summary

Definition

History and exam

Key diagnostic factors

  • hx or current dx of vascular thrombosis
  • hx of pregnancy loss
  • hx of pregnancy-associated morbidity

Other diagnostic factors

  • hx of SLE
  • features of thrombocytopenia
  • arthralgia/arthritis
  • livedo reticularis
  • hx of other rheumatological disorders or connective tissue disorders
  • cardiac murmur
  • oedema
  • seizure, headache, memory loss, signs of transverse myelopathy
  • limb discomfort, swelling, skin discoloration, and ulcers

Risk factors

  • hx of SLE
  • hx of other autoimmune rheumatological disorders
  • hx of other autoimmune diseases
  • hx of autoimmune haematological disorders

Diagnostic investigations

1st investigations to order

  • lupus anticoagulant
  • anticardiolipin antibodies
  • anti-beta2-glycoprotein I antibodies
  • ANA, double-stranded DNA, and extractable nuclear antigen antibodies
  • FBC
  • creatinine and urea
Full details

Investigations to consider

  • venous Doppler ultrasound
  • venography or MRI
  • MRI of thrombosis
  • CT angiogram of the chest
  • ventilation-perfusion (V/Q) scan
  • cranial MRI
  • echocardiography
  • thrombophilia screen
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Consultant Haematologist

Guys and St. Thomas' Foundation Trust

London

UK

Disclosures

KAB has received honoraria/speakers' fees from Bayer and Boehringer Ingelheim, and a grant from Sanofi Aventis.

Professor of Thrombosis and Haemostasis

King's College

Guys and St. Thomas' Foundation Trust

London

UK

Disclosures

BJH is a principal investigator in a trial of rivaroxaban in antiphospholipid syndrome which had a grant from Arthritis & Rheumatism Council and free drug from Bayer. BJH is Medical Director of Thrombosis UK.

Peer reviewers VIEW ALL

Consultant Rheumatologist

BHRT University Hospital

Queen’s Hospital

Romford

UK

Disclosures

KC declares that he has no competing interests.

Staff Hematologist

Cleveland Clinic Taussig Cancer Center

Cleveland

OH

Disclosures

AL declares that he has no competing interests.

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