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CMAJ • June 24, 2003; 168 (13)
© 2003 Canadian Medical Association or its licensors

Review
Synthèse

Antiphospholipid syndrome: an overview

John G. Hanly

Dr. Hanly is Professor and Head of the Division of Rheumatology, Department of Medicine, and Director of the Arthritis Centre of Nova Scotia, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, NS.

Correspondence to: Dr. John G. Hanly, Division of Rheumatology, Department of Medicine, QE II Health Sciences Centre, Suite 245, NSRC, 1341 Summer St., Halifax NS B3H 4K4; fax 902 473 7019; john.hanly{at}cdha.nshealth.ca

Abstract

ANTIPHOSPHOLIPID ANTIBODIES ARE A HETEROGENEOUS GROUP of autoantibodies that are detected by immunoassays and functional coagulation tests. The antigenic targets are negatively charged phospholipids and serum phospholipid-binding proteins. The latter antibodies are frequently associated with thrombosis, fetal loss and other clinical manifestations of the antiphospholipid syndrome. These antibodies are felt to be etiologically important in the syndrome, although the precise pathogenic mechanisms are still being determined. Proposed mechanisms include antibody-mediated interference with coagulation homeostasis, activation of platelets and endothelial cells and a T-cell immune response to serum phospholipid-binding proteins. The mainstay of therapy is anticoagulation, whereas immunosuppression is ineffective.




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