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Antiphospholipid syndrome (APS) is an autoimmune disorder defined by abnormal blood clotting and, in some cases, pregnancy-related complications, in the presence of antiphospholipid antibodies (aPL). The main antibodies are lupus anticoagulant (LA), anticardiolipin antibodies (aCL), and anti-β2 glycoprotein I antibodies (anti-β2GPI). APS can occur alone (primary APS) or in association with other autoimmune diseases, most often systemic lupus erythematosus (SLE).

Clinical features include venous thrombosis (such as deep vein thrombosis or pulmonary embolism), arterial thrombosis (such as stroke or myocardial infarction), and obstetric morbidity—recurrent miscarriages, fetal death after week 10, or premature birth due to placental dysfunction. A small subset develops catastrophic antiphospholipid syndrome (CAPS), a rapid-onset, multi-organ thrombosis requiring intensive treatment.

Diagnosis combines clinical criteria with laboratory criteria. Clinical criteria include thrombosis or specific pregnancy morbidity. Laboratory criteria require persistent positive tests for LA, aCL, or anti-β2GPI on two occasions at least 12 weeks apart. Tests must be interpreted in the absence of an alternative explanation and after excluding other causes of thrombosis.

Management depends on the manifestations. After a thrombotic event, long-term anticoagulation is standard, typically with a vitamin K antagonist such as warfarin, with target INR around 2–3 for venous events and often higher for certain arterial events. In pregnancy, treatment commonly includes heparin (often low-molecular-weight) and low-dose aspirin to reduce fetal loss and placental complications. Catastrophic APS requires urgent, multidisciplinary care including anticoagulation, plasmapheresis or IVIG.

APS is a chronic condition but prognosis improves with treatment and risk-factor modification. It is a relatively uncommon cause of autoimmune-related thrombophilia, with higher prevalence among people with SLE. Lifelong follow-up and careful monitoring of anticoagulation and pregnancy plans are advised.