Acquired Thrombotic Syndromes

00:01 Under acquired thrombotic syndromes, we'll take a look at antiphospholipid syndrome.

00:06 Highest association with SLE.

00:11 Also, you must think of it as being a connected tissue disease, so therefore, could be associated with rheumatoid arthritis in children.

00:19 So let's put all this together.

00:20 So this is an acquired type of autoimmune disease known as antiphospholipid syndrome.

00:25 So what's actually happening here is an autoimmune disease in which it is actually causing thrombi formation in a young lady.

00:33 You're gonna look for a lady that has recurrent thrombi on the venous side and the arterial side, and could also be suffering from or experiencing recurrent spontaneous abortions.

00:45 Other things about antiphospholipid syndrome, the SLE part, the lupus.

00:50 Interesting enough, what kind of situation is this? Thrombotic situation. Right? In other words, procoagulation, amazingly.

01:03 You take a cell from such a patient and you put it into a test tube in vitro.

01:10 You know what that cell does to the blood in vitro? Anticoagulate.

01:17 Why? Fascinating, I don't know.

01:20 But it does.

01:21 Hence commonly or was called Lupus anticoagulant.

01:27 Be careful though, because my patient is actually suffering from procoagulation.

01:35 Hence, recurrent DVTs, hence the recurrent spontaneous abortions.

01:43 For some reason, you take the cell out from in vivo and put it in vitro it causes anticoagulation.

01:52 Keep that in mind, let's talk a little bit more.

01:55 We have something else called anticardiolipin antibody.

01:59 What is fascinating about this is the following.

02:02 Here's once again a young lady.

02:04 She's faithful to her husband, boyfriend, what have you, to her partner, but yet, she comes back to be found positive for RPR, don't judge.

02:17 Here's a test for syphilis but she's never been promiscuous and she's been careful.

02:24 So in antiphospholipid syndrome, anticardiolipin, the antibody for some reason, the RPR will then test positive for syphilis, but false positive though is my point.

02:40 Fascinating antibody.

02:42 Here it is.

02:45 Lupus anticoagulant, do you see the significance? What's going on with my patient again? Oh, procoagulant.

02:51 You take the cell and put it into a test tube in vitro, what happens to the blood? Oh, anticoagulant, but my patient is not bleeding.

02:59 My patient is thrombotic and you must know anti-beta2-glycoprotein 1 antibody is the specific antibody that you wanna keep in mind.

03:10 There are others that have been identified but here's one that commonly shows up.

03:15 Clinically, your presentation repeated spontaneous abortions.

03:20 Why? Because of all that thrombi formation causing ischemia to the placenta.

03:24 Strokes, thrombi formation, DVT and hepatic vein thrombus up and down the body, huh? Thrombi formation taking place, autoimmune, young lady, unfortunate.