Conflict of interest

In case of pregnancy-associated APS, the health of the mother is considered always the more important. If there is a life-threatening situation, the pregnancy must be terminated. Pregnancy itself represents a higher thrombotic risk, so careful anticoagulation is extremely important. On

Thrombocytopenia may be a symptom of APS. Paradoxically, it refers to an elevated thrombotic tendency, not bleeding risk. The causes of decreased platelet number are complex: antiphospholipid antibodies that bind to platelets activate them and induce thrombosis. Thrombocytes are consumed during this process. On the other hand, thrombocytopenia is the consequence of destruction by immune mechanisms, like in the case of ITP. Sometimes, it

Diagnosis is not easy; other causes of thrombocytopenia must be excluded by careful examinations. Thrombocytopenia in APS is usually mild and per se does not require any treatment. Patients with or without thrombocytopenia require anticoagulant medication in case of venous thrombotic event while low-dose aspirin or clopidogrel is recommended after arterial thrombosis. For OAPS, the combination of anticoagulant and thrombocyte aggregation inhibitor therapy is advised. CAPS is a life-threatening disease with a rapid progression of multiorgan failure. Even application of high-dose corticosteroids, plasma exchange, intravenous immunoglobulin

the other hand, bleeding during delivery also should be avoided.

and complement inhibitor agent mortality is very high.

14. Conclusion

62 Thrombocytopenia

Abbreviations

APS antiphospholipid syndrome aPL antiphospholipid antibody

aβ2GPI anti-β2 glycoprotein 1

ACA anti-cardiolipin antibody

DOAC direct oral anticoagulants

MDS myelodysplastic syndrome

SLE systemic lupus erythematodes

LA lupus anticoagulant

CAPS catastrophic antiphospholipid syndrome

ITP immune thrombocytopenic purpura

OAPS obstetric antiphospholipid syndrome

TTP thrombotic thrombocytopenic purpura

might be the only sign of APS.

There is no conflict of interest.
