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Thanks to Sleaps for finding a more up to date article on APS Antiphospholipid Syndrome, or Hughes Syndrome as its known in the UK



Sapporo Criteria for the classification of the antiphospholipid syndrome (Wilson et al., 1999)

Clinical Criteria


1. Vascular thrombosis

One or more clinical episodes of arterial, venous, or small vessel thrombosis, in any tissue or organ. Thrombosis must be confirmed by imaging or Doppler studies or histopathology, with the exception of superficial venous thrombosis. For histopathologic confirmation, thrombosis should be present without significant evidence of inflammation in the vessel wall.

2. Pregnancy morbidity

One or more unexplained deaths of a morphologically normal fetus at or beyond the 10 th week of gestation, with normal fetus morphology documented by ultrasound or by direct examination of the fetus, or
One of more premature births of a morphologically normal neonate at or before the 34 th week of gestation because of severe preeclampsia, or eclampsia, or severe placental insufficiency, or
Three or more unexplained consecutive spontaneous abortions before the 10 th week of gestation, with maternal anatomic or hormonal abnormalities and paternal and maternal chromosomal causes excluded.
In studies of populations of patients who have more than 1 type of pregnancy morbidity, investigators are strongly encouraged to stratify groups of subjects according to a, b or c above.

Laboratory criteria

Anticardiolipin antibody of IgG and/or IgM isotype in blood, present in medium or high titer, or on 2 or more occasions, at least 6 weeks apart, measured by a standardized enzyme-linked immunosorbent assay for β 2-glycoprotein I-dependent anticardiolipin antibodies.
Lupus anticoagulant present in plasma, on 2 or more occasions at least 6 week apart, detected according to the guidelines of the International Society on Thrombosis and Hemostasis (Scientific Subcommittee on Lupus Anticoagulants/Phospholipid-Dependent Antibodies), in the following steps:
Prolonged phospholipid-dependent coagulation demonstrated on a screening test, e.g. activated partial thromboplastin time, kaolin clotting time, dilute Russell?s viper venom time, dilute prothrombin time, Textarin time.
Failure to correct the prolonged coagulation time on the screening test by mixing with normal platelet-poor plasma.
Shortening or correction of the prolonged coagulation time on the screening test by the addition of excess phospholipid.
Exclusion of other coagulopathies, e.g. factor VIII inhibitor or heparin, as appropriate.

Definite antiphospholipid antibody syndrome is considered to be present if at least 1 of the clinical criteria and 1 of the laboratory criteria are met.

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