Lab Test for the Antiphospholipid Syndrome: Define or Distort

Patients with Antiphospholipid syndrome (APS) are typically given different medications to reduce their risk of blood clotting and help normalize lab values such as platelet count. Despite this, patients sometimes internally feel that they are not doing as well as the numbers are showing.

What is Antiphospholipid Syndrome?

APS is a condition in which the immune system mistakenly attacks proteins in the blood. It is characterized by persistently positive antiphospholipid antibodies that cause blood clots to form within the arteries, veins, and organs.

Hence, symptoms may include blood clots, which may occur in the legs, arms, or lungs. Recurrent miscarriages may also be common.

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‘Using validated patient-reported outcomes measures asking how antiphospholipid syndrome patients viewed their health could become a systematic and consistent method.’

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Patients may be diagnosed with ‘primary APS’ when APS is the main autoimmune disease or ‘secondary APS’ when the APS diagnosis is paired with Lupus.

In a new study published in the American College of Rheumatology’s ACR Open, researchers found that many patients perceived their physical and cognitive function to be less than optimal.

How is Antiphospholipid Syndrome Diagnosed?

Patients with APS have many self-reported symptoms that impact different dimensions of their quality of life. However, they do not routinely receive opportunities to explain these impacts in a way that can be connected to APS.

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More often APS is studied from the perspective of the physician. Here, the authors used validated patient-reported outcome measures to ask how patients viewed their health systematically and consistently.

One hundred and thirty-nine APS patients at the University of Michigan Health were each given three questionnaires upon arrival to an appointment with their APS physician. The questionnaires asked APS patients to rate their physical function, cognitive function, and pain intensity.

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The study found that roughly half of the patients had a physical function score of less than 45, suggesting at least mild self-perceived impairment in how one can carry out their day-to-day physical activity.

While the cognitive function questionnaires have not previously been deployed as widely as those for physical function, a quarter of patients with primary APS were assigned a cognitive score of less than 40, suggesting at least moderate self-perceived impairment in this area.

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Interestingly, impairments in self-reported physical function and cognitive function, as well as higher pain intensity, were not only associated with clinical markers suggestive of more severe disease, but also with potentially modifiable lifestyle factors such as obesity and smoking status.

Distributing a questionnaire that focuses specifically on depression and SSRI use, alongside assessing impairments in cognitive function, is also likely to help us gain a better understanding of how these symptoms and associated medications impact APS patients.

As another next step, researchers hope to administer the Montreal Objective Cognitive Assessment, a standard way to objectively score cognitive function, to a larger volume of patients who also complete questionnaires.

This can help the team understand how well self-perceived cognitive function predicts actual cognitive performance.

Source-Eurekalert