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Salam,
Melisa

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Antiphospholipid syndrome



What is it?

Antiphospholipid syndrome (APS) is the name given to a disease which
involves the immune system. Normally antibodies are good and they help fight
germs or viral infections from outside, however, occasionally the immune
system makes the wrong kind - a type that acts against the body itself.
These unusual auto-antibodies in APS are detected by a blood test and when
they are present make a person more likely to get specific problems.

APS doesn't make you feel unwell or stop your immune system from working to
fight disease. You can't catch it or give it to someone else and it
certainly isn't a terminal disease or anything like that. Many people go
throughout life without even knowing their body makes these antibodies. Its
just that there's more chance of certain problems. Sometimes APS is
associated with a disease called systemic lupus erythematosis (SLE). Your
doctor will have tested for this.

It is only recently that these antibodies were discovered and their
significance understood, so the information available is somewhat limited,
but more research is being carried out on this all the time. We still don't
know exactly how the antibodies bring about the effects described below,
although we have some good ideas.


What problems can it cause?

The manifestations of APS are very variable and most people will not have
more than one of these problems. It is associated with:

  a.. Recurring miscarriage in early pregnancy
  b.. Loss of a baby after the first trimester (13 weeks)
  c.. Pre-eclampsia in pregnancy
  d.. Unexpectedly small babies
  e.. Thrombosis in a vein or artery
Part of the definition of APS is that one of these must have occurred along
with a positive antibody test.



Can these be prevented?

This is a question that much research is trying to answer, and we know that
some treatments can significantly reduce the chances of these things
happening.

Pregnancy

One of the most common and distressing problems with APS is that of
recurrent miscarriage. A promising treatment which helps prevent this is the
use of low dose aspirin in early pregnancy. This is sometimes combined with
another drug called heparin, which is given by injection.

Knowing that someone has APS means that the pregnancy can be monitored much
more closely than usual, for example with ultrasound scans to watch for poor
growth. Indeed, it may be that aspirin or heparin can help prevent these
problems too.

Thrombosis

A thrombosis is a blood clot which forms when it shouldn't do, such as in a
deep vein of the leg (DVT) or in an artery. Clots from the leg can dislodge
and move to more dangerous places such as the lung (pulmonary embolism).

APS can make someone more likely to get thrombosis, but there are times when
this is particularly important and thrombosis is already a risk, for example
after major surgery, during prolonged illness or bed rest, during pregnancy
and for a short time after delivery. During these times, extra clot
prevention may be needed. This might mean some tight medical stockings or
heparin treatment. In more severe cases of thrombosis, it may mean long-term
treatment with tablets to thin the blood. Women with APS shouldn't take the
combined (oestrogen-containing) contraceptive pill and a doctor can suggest
safer alternatives.



How common is APS?

The auto-antibodies are found in about 2% of women. Not all of these will
have had one of the problems above, so they do not necessarily have the
disease. The levels of antibody can go up and down, and even disappear, so
to definitely say someone has APS, the blood tests need to repeated at least
8 weeks from the first and still be positive. The decision on treatment at a
particular time (such as pregnancy) depends upon the levels and what
previous medical problems there were.

APS may run in families, although not all members are necessarily affected.
It isn't exactly clear to what extent this happens, but it is certainly
suggestive, for example, if several people have had a series of miscarriages
or thromboses.


What can I do?

When you get pregnant it is important to be referred to your Obstetrician as
early as possible to decide on the need for treatment with aspirin or
heparin. If you have had a thrombosis, you will have received specific
advice on treatment, but probably everyone should be encouraged to address
other risk factors for thrombosis. This includes stopping smoking, not using
the combined contraceptive pill, treating high blood pressure and
cholesterol levels.





----- Original Message -----
From: "Bambang Suseno" <[EMAIL PROTECTED]>
To: <balita-anda@balita-anda.com>
Sent: Thursday, June 22, 2006 1:07 PM
Subject: [balita-anda] ACA or Anti Cardiolipid Antibody?


>
> Dear parents,
>
> ini ada titipan pertanyaan dari temen saya...
> Dia ke dokter lalu di katakan kalu ACA istrinya masih tinggi.
> Ada yang tau atau punya file tentang ACA or Anti Cardiolipid Antibody?
>
> Regards,
> Bams
>
>
>
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