CLINICAL SIGNIFICANCE OF APTT - ANTIPHOSPHOLIPID ANTIBODY SYNDROME PRESENTING AS STROKE.

Abstract

The antiphospholipid syndrome is a systemic autoimmune disease dened by thrombotic or obstetrical events that occur in patients with persistent antiphospholipid antibodies. Anti-phospholipid antibodies (APLA) are a part of heterogeneous group of circulating serum polyclonal immunoglobulins (IgG, IgM, IgA or mixed) that bind negatively charged or neutral phospholipid component of cell membranes and cause increased tendency to venous or arterial thrombosis. Persistently positive APS requires that laboratory tests be conducted at least 12 weeks apart. We report a 67 years old pleasant lady presented with sudden onset dizziness, left sided weakness and right facial deviation for two days. In view of deranged aPTT and high clinical suspicion, Lupus anticoagulation tests were done using DRVVT which was prolonged. Tests were repeated after 12 weeks and Lupus anticoagulant remained positive. Routine aPTT detects upto 30% of APLAS, but DRVVT and Antibodies must be considered in such cases. This is a treatable condition, and can be prevented with long term anticoagulation. Key Message- Routine aPTT detects upto 30% of APLAS, but DRVVT and Antibodies must be considered in such cases. This is a treatable condition, and can be prevented with long term anticoagulation.