The Antiphospholipid Syndrome (APS)
(Adapted from an article in The Times newspaper (UK) August 20 2005)
About 20 years ago, it was reported in the British Medical Journal that a syndrome had been identified that resulted in blood becoming sticky, leading to potentially dangerous blood clots. Since then, the discovery has been confirmed as the cause of one in five miscarriages, one in five strokes in younger people and one in five DVT´s (deep vein thrombosis). Sticky blood is also strongly linked with severe headaches, migraines and infertility.
Internationally, hundreds are now attending lectures on this condition. The dean of medicine in Barcelona University has said that there are just two new diseases of the late 20th Century - Aids and Antiphospholipid syndrome.
Yet, we´re hardly making the most of a great discovery. It is believed that only a handful of General Practitioners are alert to the condition and this lack of knowledge causes thousands of people to suffer needlessly - and thousands of unnecessary miscarriages. "Bit by bit, obstetricians and neurologists are picking up on it but GPs aren´t". "It´s not easy to pick up because sticky blood can affect every organ in the body. The commonest problems people have are migraines, headaches and memory loss. Some cases are picked up in infertility clinics and there is now a simple blood test provided to some women who have had two or more miscarriages. But it is not offered routinely".
It started in the early 1970´s when specialists treating Lupus cases were struck by the number of people who seemed to have a collection of symptoms - memory loss, migraines, balance problems, recurrent miscarriage, fluctuating blood pressure and recurrent thrombosis - who then went on to have strokes and heart attacks. Testing of their blood found that all had high levels of a kind of antibody that destroys phospholipid - a fat found in blood cells.
It was clear that these symptoms were not simply lupus symptoms. Further investigation revealed specialists in other fields reporting similar problems. Liver clinics reported people with liver clots who also displayed memory loss, fluctuating blood pressure and so on. The same pattern appeared in epilepsy, multiple sclerosis, pregnancy and headache clinics. All the patients with these symptoms also revealed high levels of antiphospholipid syndrome.
Since 1983, a host of research papers has been published, tracing the antiphospholipid syndrome as a key factor in a range of diseases.
In people with the genetic predisposition to the syndrome, a virus appears to trigger the release of antiphospholipid antibodies into the blood. These attack the slippery coating of the blood cells, so they become sticky, jam together and cause clots. Since clotting can affect every sphere of medicine, the syndrome can be at the root of many conditions. In pregnancy, clots block the placenta causing it and the foetus to wither and die. In neurological conditions, such as memory loss, the clots impair the blood flow to the brain.
Research in St Thomas´s London is revealing that many people with antiphospholipid syndrome are being misdiagnosed as having multiple sclerosis. "Thirty per cent of people with this syndrome have that label hanging over them at some stage".
Once antiphospholipid syndrome is diagnosed through a blood test, then it can be easily controlled. Taking aspirin, or anticoagulants such as heparin and warfarin, produces a dramatic reduction in symptoms in 80% of patients.
Sadly, until doctors throughout the UK (and the rest of the world) become aware of sticky blood, known by doctors as antiphospholipid syndrome, the full implications are unlikely to be realised.
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