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Síndrome antifosfolípido

  • Обзор
  • Теория
  • Диагноз
  • Лечение
  • Последующее наблюдение
  • Источники
Последний просмотренный: 20 Aug 2025
Last updated: 16 Aug 2024

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • antecedentes o diagnóstico actual de trombosis vascular
  • anamnesis de pérdida del embarazo
  • antecedentes de morbilidad asociada al embarazo
Полная информация

Другие диагностические факторы

  • antecedentes de lupus eritematoso sistémico
  • características de la trombocitopenia
  • artralgia/artritis
  • livedo reticularis
  • antecedentes de otros trastornos reumatológicos o del tejido conectivo
  • soplo cardíaco
  • edema
  • crisis convulsiva, cefalea, pérdida de memoria, signos de mielopatía transversa
  • molestia en las extremidades, inflamación, decoloración de la piel y úlceras
Полная информация

Risk factors

  • antecedentes de lupus eritematoso sistémico
  • antecedentes de otros trastornos reumatológicos autoinmunitarios
  • antecedentes de otras enfermedades autoinmunitarias
  • antecedentes de trastornos hematológicos autoinmunitarios
Full details

Diagnostic tests

1st tests to order

  • anticoagulante lúpico
  • anticuerpos anticardiolipina
  • anticuerpos anti-beta2-glucoproteína I
  • anticuerpos antinucleares, ADN de doble cadena y antígenos nucleares extraíbles
  • hemograma completo (HC)
  • creatinina y urea
Full details

Tests to consider

  • ultrasonido Doppler venoso
  • venografía o resonancia magnética (IRM)
  • resonancia magnética (IRM) de la trombosis
  • angiografía de tórax por tomografía computarizada (TC)
  • gammagrafía de ventilación-perfusión (V/P)
  • resonancia magnética (IRM) craneal
  • ecocardiografía
  • prueba de trombofilia hereditaria
Full details

Treatment algorithm

ACUTE

no embarazadas con trombosis aguda

embarazadas

síndrome antifosfolípido (SAF) catastrófico (embarazadas y no embarazadas)

ONGOING

anticuerpos antifosfolípidos incidentales

Contributors

Authors

Damon Houghton, MD, MS

Associate Professor of Medicine

Mayo Clinic

Gonda Vascular Center

Department of Internal Medicine, Division of Hematology & Department of Cardiovascular Diseases, Division of Vascular Medicine

Rochester

MN

Disclosures

DH has received clinical research support from Veralox and Bayer.

Ana I. Casanegra, MD, MS

Associate Professor of Medicine

Mayo Clinic

Gonda Vascular Center

Department of Cardiovascular Diseases, Division of Vascular Medicine

Rochester

MN

Disclosures

AC declares that she has no competing interests.

Alí Duarte-García, MD, MSc

Assistant Professor of Medicine

Mayo Clinic

Department of Internal Medicine, Division of Rheumatology

Rochester

MN

Disclosures

AD declares that he has no competing interests.

Acknowledgements

Dr Damon Houghton, Dr Ana I. Casanegra and Dr Alí Duarte-García would like to gratefully acknowledge Dr Karen A. Breen and Dr Beverley J. Hunt, the previous contributors to this topic. KAB has performed consultancy work for Bayer/Pfizer. BJH is Medical Director of Thrombosis UK and chair of the steering committee for World Thrombosis Day. BJH is an author of a reference cited in this topic.

Peer reviewers

Kuntal Chakravarty, FRCP (London), FRCP (Glasgow), FRCP (Ireland), FACP (USA), FACR (USA)

Consultant Rheumatologist

BHRT University Hospital

Queen’s Hospital

Romford

UK

Disclosures

KC declares that he has no competing interests.

Alan Lichtin, MD

Staff Hematologist

Cleveland Clinic Taussig Cancer Center

Cleveland

OH

Disclosures

AL declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Miyakis S, Lockshin MD, Atsumi T, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006 Feb;4(2):295-306.Full text  Abstract

Barbhaiya M, Zuily S, Naden R, et al. 2023 ACR/EULAR antiphospholipid syndrome classification criteria. Ann Rheum Dis. 2023 Oct;82(10):1258-70.Full text  Abstract

Tektonidou MG, Andreoli L, Limper M, et al. EULAR recommendations for the management of antiphospholipid syndrome in adults. Ann Rheum Dis. 2019 Oct;78(10):1296-304.Full text  Abstract

Sammaritano LR, Bermas BL, Chakravarty EE, et al. 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases. Arthritis Rheumatol. 2020 Apr;72(4):529-56.Full text  Abstract

American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 132: antiphospholipid syndrome. Dec 2012 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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  • Guidelines

    • ACR/EULAR antiphospholipid syndrome classification criteria
    • 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal disease
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  • Patient information

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