Acquired thrombophilia / hypercoagulopathies

Antiphospholipid antibodies

Topic Completed: 1 April 2013

Minor changes: 11 September 2020

Copyright: 2003-2022,, Inc.

PubMed Search: Antiphospholipid antibodies [title]

Jeremy C. Parsons, M.D.
Page views in 2021: 842
Page views in 2022 to date: 37
Cite this page: Parsons JC. Antiphospholipid antibodies. website. Accessed January 17th, 2022.
Definition / general
  • Acquired antibodies against phospholipid - protein complexes
  • Occurs in 3 - 5% of general population; most common cause of acquired thrombophilia
  • Rate of thrombosis per year is 1% if no history of thrombosis, 4% in systemic lupus erythematosus (SLE) patients, 5.5% in patients with a history of thrombosis, 6% if high titer of IgG anticardiolipin
  • Includes lupus anticoagulant (most patients do not have SLE), anticardiolipin antibody, and anti β2 glycoprotein antibodies
  • Antibodies are against phospholipids (usually transient, secondary to infection) or various plasma protein antigenic targets (β2-glycoprotein I, protein C, protein S, annexin V, high and low molecular weight kininogens, thrombomodulin, prothrombin, factors XI and XII, complement factor H)
  • First described by Wassermann in 1906 (Wasserman test was complement fixation procedure using saline liver extracts from fetuses with congenital syphilis)
  • Associated with an increased risk of arterial or venous thrombosis, thrombocytopenia, recurrent miscarriages; causes 1 / 3 of strokes in patients younger than age 50 years (often due to mitral or aortic valve emboli), 15% of deep venous thromboses, 5 - 15% of recurrent spontaneous abortions, eclampsia, maternal DVT's; also multi - infarct dementia, chorea, migraine, livedo reticularis in skin
  • Catastrophic antiphospholipid syndrome resembles TTP-HUS

  • Antiphospholipid antibody syndrome: diagnosis requires a positive lupus anticoagulant or anticardiolipin antibody on two separate occasions, at least 6 - 12 weeks apart, AND either venous or arterial thrombosis, thrombocytopenia or recurrent fetal loss
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