Actualización del tratamiento del síndrome antifosfolipídico: una revisión bibliográfica

Abstract

Antiphospholipid Syndrome (APS) is a systemic autoimmune disease characterized by the presence of antiphospholipid antibodies, associated with thrombotic events, microvascular diseases, and severe obstetric complications such as preeclampsia and recurrent pregnancy loss. Its diagnosis is based on clinical and laboratory criteria, including evident thrombosis, pregnancy-related alterations, and specific antibodies, according to the Sapporo criteria. The pathophysiological mechanisms involve an immune response that generates a prothrombotic, proadhesive, and proinflammatory state, affecting the endothelium and activating various cellular and molecular components. Timely diagnosis is crucial to prevent serious complications and is achieved through the combination of clinical manifestations and laboratory tests, such as anticardiolipin antibodies and anti-beta 2-glycoprotein-1. Treatment of APS is controversial, especially regarding the use of low-dose aspirin for primary prophylaxis, although its efficacy comparable to moderate-dose anticoagulation post-thrombotic events has been demonstrated. In the obstetric context, APS presents with specific obstetric complications, and the identification of obstetric criteria contributes to its diagnosis, highlighting the importance of new biomarkers such as complement 4.