Clinical Implications of Anti-Phospholipid Antibodies: The Utah Experience
2020
In the summer of 1983, we recognized our first patient with fetal loss associated with anti-phospholipid antibodies (aPL). She had three previous second trimester fetal deaths and a deep venous thrombosis complicating one of her pregnancies. Only a few weeks later, Lubbe and colleagues reported that fetal death in women with aPL might be avoided by treatment with corticosteroids and low-dose aspirin. The highest frequency of patients with significant levels of aPL is found among those with clinically obvious autoimmune diseases, particularly systemic lupus erythematosus. Pregnancy also induces changes in the balance between hemostasis and fibrinolysis. In view of the apparent risk of venous thrombosis and stroke in pregnant women with aPL, one cannot help but wonder to what extent aPL contribute to the overall problem of pregnancy- or oral contraceptive-related thromboembolism. Those patients within the geographic region were managed at the University of Utah Clinics and Hospital.
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