Treatment: Antiphospholipid Syndrome

• After first thrombotic event, warfarin for life to achieve an international normalized ratio (INR) 2.5-3.5.
• Pregnancy morbidity prevented by heparin with aspirin 80 mg daily. IV immunoglobulins (IVIG) may also prevent pregnancy loss. Glucocorticoids are ineffective.
• For CAPS, consider anticoagulation, glucocorticoids, plasma exchange, and IVIG.

For a more detailed discussion, see Hahn BH: Systemic Lupus Erythematosus, Chap. 378, p. 2124; Shah A, St. Clair EW: Rheumatoid Arthritis, Chap. 380, p. 2136; Varga J: Systemic Sclerosis (Scleroderma) and Related Disorders, Chap. 382, p. 2154; Moutsopoulos HM, Tzioufas AG: Sjögren's Syndrome, Chap. 383, p. 2166; Moutsopoulos HM, Vlachoyiannopoulos PG: Antiphospholipid Syndrome, Chap. 379, p. 2134, in HPIM-19.