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Antiphospholipid syndrome - Symptoms of antiphospholipid syndrome (APS)

NHS Choices Medical Reference

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In antiphospholipid syndrome (APS), the immune system produces abnormal antibodies which make the blood stickier than normal.

This doesn't always cause any noticeable problems, but some people with APS have general symptoms that can be similar to those of multiple sclerosis (a common condition affecting the central nervous system). These include:

People with APS may also experience repeated headaches or migraines.

They are more likely to develop blood clots in their veins and arteries. This can cause serious, life-threatening health problems such as deep vein thrombosis (DVT), strokes or heart attacks.

Below are the most common conditions that can be caused by APS. However, most people with APS will not experience all of these.

Deep vein thrombosis

Deep vein thrombosis (DVT) is one of the most common conditions that can occur as a result of APS. It is a blood clot that develops inside one of the body's larger, deeper veins, usually in the calf or thigh.

Symptoms of DVT can include:

  • pain, swelling and tenderness in one of your legs (usually only one leg is affected)
  • a heavy ache in the affected area
  • warm skin in the area of the clot
  • redness, particularly at the back of your leg, below the knee

One of the biggest risks is that the blood clot may move out of your leg and travel towards your lungs. A blood clot that reaches the lungs is known as a pulmonary embolism.

Pulmonary embolism

A pulmonary embolism is a blockage in one of the blood vessels in the lungs. Most pulmonary embolisms occur when a blood clot that develops in one of the legs travels up into the lungs. Symptoms of a pulmonary embolism can include:

A pulmonary embolism can be life-threatening if not treated, so you should seek immediate medical help if you have the symptoms above.

Strokes and TIAs

A stroke is a serious condition that is sometimes associated with APS. A stroke happens when a blood clot blocks the brain's blood supply.

The most effective way of identifying the symptoms of a stroke is to remember the word FAST, which stands for:

  • Face - the face may have fallen on one side, the person may not be able to smile, or their mouth or eye may have dropped.
  • Arms - the person may not be able to raise both arms and keep them there due to weakness or numbness.
  • Speech - speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake.
  • Time - it's time to dial 999 immediately if there are any of these signs or symptoms.

A transient ischaemic attack (TIA), also known as a 'mini-stroke', happens when a blood clot causes a temporary blockage of blood to the brain.

TIA symptoms are the same as those of a stroke, but they only last from a few minutes to a few hours before they disappear. However, a TIA should never be ignored because it is a serious warning sign of a problem with the brain's blood supply. You should dial 999 for an ambulance immediately if you think you or someone else has had a TIA.

Heart attacks

A heart attack can occur when a blood clot forms in one of the blood vessels leading to the heart (coronary arteries).

If the blood clot blocks the blood supply to your heart, it can seriously damage the heart muscles, which can die if left untreated.

Symptoms of a heart attack can include:

  • chest pain, which is usually located in the centre of your chest and can feel like a sensation of pressure, tightness or squeezing
  • pain in other parts of the body, as if the pain is travelling outwards from your chest
  • shortness of breath
  • feeling or being sick
  • an overwhelming sense of anxiety (similar to having a panic attack)
  • feeling light-headed
  • coughing
  • wheezing

Dial 999 immediately if you think that you or someone else is having a heart attack.

Pregnancy problems

Women with APS have a much higher risk of developing complications during pregnancy, particularly if it is not treated. Possible complications include:

  • recurrent (three or more) early miscarriages, usually during the first 10 weeks of pregnancy
  • one or more later miscarriages, usually after week 10 of pregnancy
  • premature birth, usually at or before week 34 of pregnancy, which may be caused by pre-eclampsia (where a woman develops high blood pressure during pregnancy)

Livedo reticularis

Livedo reticularis is a skin condition caused by small blood clots that develop inside the blood vessels of the skin.

It causes the skin to take on a blotchy red or blue appearance. Some people also develop ulcers (sores) and nodules (bumps). These symptoms are often more severe in cold weather.

Superficial thrombophlebitis

Superficial thrombophlebitis is inflammation of the veins just under your skin, usually in your leg. The symptoms are similar to DVT but they are not usually as severe.

The symptoms of superficial thrombophlebitis include swelling, redness and tenderness along the affected vein and a high temperature of 38°C (100.4°F) or above (although this is less common). The symptoms usually resolve within two to six weeks.

Medical Review: November 06, 2013
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