<prompt> In a patient with Anti-Phospholipid Antibody syndrome, which of the following treatment is used to prevent further abortions?Aspirin LMWHCorticosteroidsIV immunoglobulinsPlasmapheresis  <response>: Ans. a. Aspirin LMWH Ref: Harrison 19e p2134. 18e p2737Aspirin and low molecular weight heparin LMWH is used to prevent further abortions in patients of Anti-Phospholipid Antibody syndrome.After the first thrombotic event, APS patients should be placed on warfarin for life aiming to achieve an international normalized ratio TNR ranging from 2.5 to 3.5, alone or in combination with 80 mg of aspirin daily. Pregnancy morbidity is prevented by a combination of heparin with aspirin 80 mg daily. Intravenous immunoglobulin IVIg 400 mgkg qdfor 5 days may also prevent abortions, while glucocorticoids are ineffective. - Harrison 18e p2737Antiphospholipid Antibody Syndrome APSDefined by a clinical association of antiphospholipid antibodies and hypercoagulabilityQConsidered a systemic autoimmune disease which is characterized by recurrent thrombosis or pregnancy complications, along with the presence of Antiphospholipid antibodiesQPrimary APS: No cause is identified; Secondary APS: Defined cause like SLE is identifiedClinical Features:Vascular ThrombosisPregnancy MorbidityVenous thrombosis More common Recurrent arterial or venous thrombosis in any tissue or organ is the most common presentationQ Recurrent spontaneous abortionsQ Pregnancy induced hypertensionQ Preeclampsia and eclampsia Placental Insufficiency AbruptionQ Intrauterine Growth RetardationQ DVT is the MC manifestationQ Pulmonary EmbolismQ Pulmonary hypertension from thromboembolic disease Arterial thromobosis less commonCNSHeartLungsKidneyBonesStrokeQ Cerebral vessel occlusionMyocardial infarctionQ coronary occlusionPulmonary hypertensionQPulmonary artery occlusionGlomerular thrombosisQRenal artery thrombosisQAvascular necrosis Antiphospholipid Antibody Syndrome APS: Laboratory Features Elevated Anticardiolepin antibodiesQ IgG or lgMQ Elevated Anti b-2 glycoprotein-1 AntibodyQ ThrombocytopeniaQ Presence of Lupus Anticoagulant LA in plasmaQ Hemolytic anemiaQ Coombs positiveEvans syndrome refers to the clinical association of autoimmune thrombocytopenia and autoimmune hemolytic anemiaQ.Evans syndrome has been reported in 10 of patients with Antiphospholipid syndromeTreatment:The mainstay of treatment of Antiphospholipid Syndrome is WarfarinQ.After the first thrombotic event, APS patients should be placed on warfarin for life aiming to achieve an international normalized ratio INR ranging from 2.5 to 3.5, alone or in combination with 80 mg of aspirin daily.Pregnancy morbidity is prevented by a combination of heparin with aspirin 80 mg daily.Intravenous immunoglobulin IVIg 400 mgkg qd for 5 days may also prevent abortions, while glucocorticoids are ineffectiveQ. 