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Does Antiphosfolipid Factor 5 Remain Dormant In Body?

Posted on Wed, 19 Mar 2014

Question: Hello there, I would like to know if someone was diagnosed lets say with antiphosfolipid factor 5, could this condition be dormant in there bodies until an accident occurred or does it mean it is inevitable that they will at some point suffer a clotting incident? Thank you XXXXXXX

Answered by Dr. Rakesh Madhyastha (7 hours later)

Brief Answer: Need more info Detailed Answer: Hello Thanks for the query I understand that a patient has been diagnosed with ?APLA ( anti phospholipid antibody ) syndrome and was probably on steroids and has now stopped taking them. I need to know more information in order to come to a conclusion if they are prone for thrombosis ( clotting) 1. Is he still on low dose steroids? 2. Any anitcoagulants like aspirin, warfarin are still going on? 3. ANy previous incidence of clotting? 4. Any other co morbid conditions like diabetes, high cholesterol, etc 5. When were the steroids stopped? How long did he take them? 6. Please tell me the weight and height of the patient Please get back to me, I am awaiting your reply Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (40 hours later)

Good morning DR. Madhyastha, I'm looking for an unbiased opinion and I'm hypothetically asking, in scenario, If a person e.g. A 44 y.o man is not aware of this precondition, no previous incidences to clotting even with many incidences of minor injuries, not on any medications, no diabetes no high cholesterol, is 5'8 200 lbs. and is otherwise healthy. So hence my question, if a person has APLA, not on any medication, no diabetes, no high cholesterol and suffers NO serious bodily injury in the past or future, would the ONSET of a blood clot be INEVITABLE somewhere in his body (simply by having this condition) in there lifetime? Thank you for your opinion. Sincerely, XXXXXXX

Answered by Dr. Rakesh Madhyastha (6 hours later)

Brief Answer: Hello Detailed Answer: Good morning XXXXXXX Thanks for clarifying and the answer is YES. This 44 year old man will be prone for thromboses ( blood clot) and it would be inevitable. It can happen anywhere in his body, any moment of time. I hope I was of help REgaeds

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (17 hours later)

Good morning again Dr. Madhyastha, Thank you very much for your response, so then I have just one more question I promise, hypothetically If a person with APLA suffers a compartment syndrome situation, attends ER and has a fasciotomy or decompression performed immed, would the prospect of his limb be most probably saved or most likely not because of his precondition? Meaning is it possible for example to save an ischemic leg having the diagnosis of APLA or not? Thank you so much for your opinions. Regards, XXXXXXX

Answered by Dr. Rakesh Madhyastha (8 hours later)

Brief Answer: Hello Detailed Answer: Thanks for getting back I enjoy answering your questions, it's different and nice. You can ask how many ever you want. If the patient is a known case of APLA and has come to the ER and the surgery was done as an emergency then INR is brought back to normal with fresh frozen plasma and then taken up for the surgery however post operatively low molecular weight heparin is started to prevent thrombosis even if Apla titres are less than 40. So I would say ischemia post operatively is about the same as someone without apla if proper precautions are taken Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (2 hours later)

Hello again Dr. and thank you once again for your response, I truly appreciate you allowing me to ask you some more questions:) So for clarification purposes your saying that when dealing with an ischemia scenario it doesn't really matter if a person has APLA or not at the time because the limb can be saved in both cases? can you tell me is it difficult to diagnose compartment syndrome? and is there a timeframe when it would become to late to save a limb? I just returned from emerg. and I have been diagnosed with Shingles, the rash is at the back of my head and neck area and unfortunately I had rubbed my eyes several times after touching the back of my hair before I knew what the diagnosis was. unfortunately I forgot to ask the doctor that by doing so can I go blind, is this possible with this condition??? Sorry this is off my previous topic Ok I think that's it and thanks again Regards, XXXXXXX

Answered by Dr. Rakesh Madhyastha (24 hours later)

Brief Answer: Hello Detailed Answer: You have understood what I said a little differently. What I meant was whether or not someone has apla, the management would be the same but whether the outcome of a healthy individual vs an apla patient has to be studied, there has not been any study comparing the outcomes but judging by the patho physiology of the apla syndrome the chances of ischemia in them must be higher however a known case of apla will receive post care to prevent ischemia. To sum it all up. A known case of apla syndrome patient must have similar outcome of a compartment syndrome as he will receive careful post op care. I hope I didn't confuse you further Herpes zoster ophthalmicus is known however it is seen very rarely. I suggest you go back to your doctor if you develop symptoms like itchy eyes, tearing, redness or pain. It is a self limiting infection, make sure you do not scratch the lesions. Scarctching the lesions often leaves a permanent scar I wish you a speedy recovery Regards

Note: For detailed guidance on genetic screening consult a genetics specialist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar