Antiphospholipid syndrome

The risk of first thrombosis or recurrent thrombosis in patients with antiphospholipid antibodies is highly variable; some run a high risk of recurrent thrombosis, while others seem to have very low risk despite exposure to prothrombotic risk such as pregnancy or post-major surgery. The best predictor of risk in future pregnancies is the previous obstetric history: for example, those with a history of second-trimester HELLP syndrome (haemolysis, elevated liver enzymes, and low platelet count) have a high risk of HELLP recurrence without treatment. Population studies have shown that the presence of the lupus anticoagulant and/or high titres of anticardiolipin antibodies and/or positivity for both lupus anticoagulant and anticardiolipin antibodies, as opposed to positivity for only 1 assay, have higher risk.[29]Knight JS, Branch DW, Ortel TL. Antiphospholipid syndrome: advances in diagnosis, pathogenesis, and management. BMJ. 2023 Feb 27;380:e069717. https://www.bmj.com/content/380/bmj-2021-069717.long http://www.ncbi.nlm.nih.gov/pubmed/36849186?tool=bestpractice.com ​ However, estimating future risk of thrombosis based on these population studies is not possible.

See HELLP syndrome.