Abstract
Detection of antiphospholipid antibodies (aPL) are central to the definition of the
antiphospholipid (antibody) syndrome (APS). Thrombosis in certain vascular beds, such
as the cerebral circulation, the veins of the lower legs and cutaneous vessels, and/or
fetal loss, are common manifestations of APS. However, aPL have been found in association
with a large range of other clinical conditions—these conditions constitute a rather
heterogeneous group and are the subject of this review. Thus, aPL may rarely be found
in association with thromboses of vascular beds other than those commonly associated
with APS. The combination of thrombosis and aPL still satisfies the criteria for APS,
and management of this group of patients is the same as that of APS associated with
the more common manifestations of the disease. Alternatively, aPL may be detected
in a range of conditions where thrombosis cannot be clearly demonstrated, such as
duodenal ulcer or transverse myelopathy. The approach to management of patients who
have aPL in association with these conditions is less clear, although in some cases
interventions to remove the associated antibody have been associated with amelioration
of the condition. Finally, in several studies, aPL have been detected in a proportion
of patients with conditions occurring commonly in the normal population—these findings
have to be treated with caution in view of inconsistent findings between the reported
results and methodological limitation of studies purporting to show positive results.
Keywords
antiphospholipid antibodies - antiphospholipid syndrome - thrombosis - rare associations
