Situations which require to test for antiphospholipid antibodies (APS)

The following are considered as indications for testing for antiphospholipid antibodies:

• thrombosis
  • arterial thrombosis before the age of 50
  • unprovoked venous thrombosis before the age of 50
  • recurrent thrombosis
  • thrombosis at an unusual site
  • patients with both arterial and venous thrombotic events
  • any patient admitted with thrombotic microangiopathy of unknown aetiology
    
    
• obstetric manifestation
  • one or more unexplained fetal loss after 10 weeks gestation
  • unexplained severe intrauterine growth restriction
  • early or severe pre-eclampsia
  • three or more spontaneous miscarriages before 10 weeks of gestation
    
    
• patients with SLE
  • at baseline
  • repeat testing before pregnancy, surgery, transplantation and use of oestrogen containing treatments or in the presence of new neurological, vascular or obstetric event (1)

Reference:

• (1) Cohen D et al. Diagnosis and management of the antiphospholipid syndrome. BMJ. 2010;340:c2541