C H E E K Y L I T T L E S M I L E;
Oct 11, 2015
Antiphospholipid Syndrome or Sindrom Antiphospholipid (APS)



Hey peeps, today I'm gonna tell some information about Antiphospholipid Syndrome (APS). Which I am one of the survivor. It has been more than a year since I was diagnosed with SLE, APS, Lupus Nephritis with Nephrotic Syndrome and Left Renal Vein Thrombosis. And in early this year, after done biopsy on my left kidney, doctors told me that I'm having Lupus Nephritis Class V. Which Class V is the second last or the third last stage (I'm not sure though) of Lupus Nephritis and fortunately Class IV is the last stages in Lupus Nephritis. Although in normal numerical, V is worst than IV. But my doctor said that Class IV is the worst which most of their kidney is damage. Some people with Class IV need to do dialysis or CAPD because they can't save their kidney anymore. In Lupus Nephritis, there's 6 stages of lupus nephritis. Class V happened when there's excessive protein loss and swelling. In this stage, doctors will treat with high amounts of corticosteroids. Doctors tell me that Lupus Nephritis Class V is hard to treat. Sometimes the very the most powerful drug can't overcome this disease. I'd ate the maximum dose of cellcept, spent several thousand on cellcept but protein still leaking from my kidney. Okay enough about me. Now I'm gonna share some information that I got from one of the article that I read in Berita SLE.

Article in English


Dr. Graham Hughes from St. Thomas Hospital, London first described a condition called "Antiphospholipid Syndrome" (APS) in Lupus patient. He described it as "sticky blood syndrome", a condition that cause thickening of the blood thereby making the blood clot more easily. This syndrome is also named after Dr. Hughes as "Hughes Syndrome".


It can affects both men and women, young and old. And as in lupus, the reason that the blood being sticky is that the patient has auto-antibodies, in this can auto-antibodies against phospholipid, one of the components present on blood cells and on the lining of blood vessels.

The various antiphospholipid antibodies:
  1. Anticardiolipin Antibody
  2. Lupus Anticoagulant
  3. Beta-2 Glycoprotein-1 Antibody
This antiphospholipid antibodies increase the tendency for the blood to clot and are therefore associated with problems related to abnormal blood clotting. (Eg: miscarriages, deep vein thromboses (blood cloth in the veins of the legs and arms), pulmonary emboli (blood clots in the lung), and strokes, presence migraine headaches and low platelet counts (thrombocytopenia))

The main symptoms of APS:

1. Headache / Migraine
The patient may have regular attacks of headache.

2. Memory Loss
When the brain is starved of oxygen (or its blood supply), a common symptom is memory loss. Many patients can't remember names of their friends and family, forget their shopping lists and get their words and sentences muddled.

3. Visual Disturbance
A person with APS can experience double vision / sudden visual loss. This can be caused by the brain reacting to disturbances in its supply of blood / by the veins and arteries in the eye being effected. 

4. Skin disorders
A blotchy appearance of the skin of the arms and legs, described in medical textbooks as "livedo reticularis" or  "corned beef skin". It also cause repeated sores (ulcers) and bumps (nodules) of the skin

5. Thrombosis (DVTs)
It can occur in the untreated patient at any time in any part / organ of the body. DVTs can form in the arms / legs after a long journey. Clots in the veins can cause inflammation of the veins (thrombophlebitis) of the legs with pain in the tight or calf, swelling of the legs, and sometimes a visible red, thickened blood vessel. It can also affect vital organs such as the eye, liver and kidney.

6. Heart Attack (Arterial Thrombosis) 
APS can lead to heart attack and can create clots in the upper chambers of the heart.

7. Stroke
The most feared complication of blood clotting is strokes causing paralysis.

8. Pulmunory Embolism 
A lung embolus (pulmonary embolism) occurs when a blood vessel supplying the lung becomes clogged up by a clot - a lump of coagulated blood. Blood clot in the lung can cause chest pain, shortness of breath, and rapid breathing.

9. Pregnancy problems
There can be recurrent miscarriages without any other obvious cause.

10. Multiple Sclerosis


11. Gastrointestinal disorders



Diagnosis and treatment for APS


The diagnosis of APS would usually be made by doctor who treating the patient for SLE / a rheumatologist (a doctor who specialises in treating arthritis and autoimmune disorders) / haematologist (a doctor who specialises in treating blood conditions). APS is diagnosed from a combination of typical symptoms together with blood tests to detect the antiphospholipid antibodies.

Treatment is with low-dose aspirin and/or heparin. In patient who have had blood clots, they will need to take anti-coagulants (medicines to thin the blood) for the rest of their lives.

Article in Bahasa Malaysia

Dr. Graham Hughes dari Hospital St. Thomas, London menghuraikan keadaan yang dikenali sebagai  "Sindrom Antiphospholipid" (APS) dalam pesakit lupus. Beliau menghuraikan ia sebagai "sindrom darah melekit", satu keadaan yang mengakibatkan darah memekat dan seterusnya membuat darah lebih mudah membeku. Sindrom ini turut mengambil nama Dr. Hughes dan dikenali sebagai "Sindrom Hughes".

Keadaan ini dialami oleh lelaki dan wanita, muda dan tua. Dan seperti lupus, darah menjadi melekit kerana pesakit mempunyai auto-antibodi, dalam hal ini boleh auto-antibodi terhadap phospholipid, salah satu komponen yang hadir pada sel-sel darah dan di dalam lapisan saluran darah.

Pelbagai antibodi Antiphospholipid:
  1. Anticardiolipin Antibodi
  2. Lupus koagulan
  3. Beta-2 Glycoprotein-1 Antibodi
Antibodi Antiphospholipid ini meningkatkan kecenderungan untuk darah membeku dan berikutan itu dikaitkan dengan masalah yang berkaitan dengan pembekuan darah yang tidak normal. (Contoh: keguguran, thrombosis vena dalam (darah beku dalam urat kaki dan tangan), embolus pulmonari (darah beku dalam paru-paru), dan strok, sakit migrain dan kiraan platelet yang rendah (thrombocytopenia))

Simptom - simptom utama APS:

1. Sakit kepala / Migrain
Pesakit mungkin mengalami sakit kepala yang kerap.

2. Hilang Daya Ingatan
Apabila otak kekurangan oksigen (atau bekalan darah), gejala yang biasa berlaku adalah hilang daya ingatan. Ramai pesakit tidak dapat ingat nama-nama rakan-rakan mereka dan keluarga, lupa senarai barang mereka yang perlu dibeli dan mencampur adukkan perkataan dan ayat dan kata - kata mereka.

3. Gangguan Visual
Pesakit APS boleh mengalami penglihatan berbalam dan kehilangan penglihatan secara tiba-tiba. Ini boleh disebabkan oleh otak bertindak balas kepada gangguan terhadap bekalan darah atau akibat kesan terhadap urat dan arteri dalam mata.

4. Masalah kulit
Tompokan pada kulit tangan dan kaki, yang digambarkan dalam buku-buku perubatan sebagai "livedo reticularis" atau "kulit konbif". Ia juga menyebabkan kudis berulang (ulser) dan lekukan (nodul) pada kulit

5. Thrombosis (DVTs)
Ia boleh berlaku pada pesakit yang tidak dirawat pada bila-bila masa mana-mana bahagian / organ badan. DVTs boleh membentuk di tangan / kaki selepas perjalanan yang panjang. Darah beku dalam saluran darah boleh menyebabkan radang urat (thrombophlebitis) kaki rasa sakit di bahagian paha dan betis, pembengkakan kaki, dan kadang-kadang saluran darah yang jelas kelihatan merah dan membengkak. Ia juga boleh menjejaskan organ-organ penting seperti mata, hati dan buah pinggang.

6. Serangan Jantung (Arterial Thrombosis)
APS boleh megakibatkan serangan jantung dan boleh mewujudkan darah beku di atas jantung.

7. Strok
Strok yang mengakibatkan kelumpuhan merupakan komplikasi yang paling digeruni.

8. Pulmunory Embolisme
Embolus paru-paru (embolisme pulmonari) berlaku apabila saluran yang membekalkan darah paru- paru menjadi tersumbat oleh darah beku . Gumpalan sedemikian di dalam paru-paru boleh menyebabkan sakit dada, sesak nafas, dan pernafasan pantas.

9. Masalah Kehamilan
Keguguran berulang boleh berlaku tanpa apa-apa sebab yang jelas.

10. Multiple Sclerosis

11. gangguan gastrousus

Diagnosis dan rawatan untuk APS

Diagnosis APS biasanya akan dibuat oleh doktor yang merawat pesakit untuk SLE / pakar reumatologi (seorang doktor yang pakar dalam merawat arthritis dan gangguan autoimun) / pakar hematologi (seorang doktor yang pakar penyakit darah). APS didiagnosis daripada kombinasi simptom lazimnya bersama ujian darah untuk antibodi Antiphospholipid.

Rawatannya adalah dengan aspirin dos rendah dan / atau heparin. Pesakit - pesakit yang mempunyai darah beku, mereka perlu mengambil anti-koagulan (ubat untuk mencairkan darah) sepanjang hidup mereka.


That's some information about APS that I can share with you. Learn SLE and help us to find a cure for lupie. Learn the dificulties that they suffered. Someone in your life might suffer this disease.

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