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Antiphospholipid syndrome — MCCQE Part 1 MCQ

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HardRecurrent ThrombosisAntiphospholipid syndromeMCCQE Part 1

A 40-year-old woman has recurrent DVTs, pregnancy losses (2 second-trimester, 1 first-trimester), and thrombocytopenia. Lupus anticoagulant positive on two occasions 14 weeks apart. Most likely diagnosis?

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Correct answer: E — Antiphospholipid syndrome

Revised Sapporo criteria: >=1 thrombosis or pregnancy morbidity + persistent APL (>=12 weeks apart). Lifelong anticoagulation after thrombosis. Warfarin preferred (DOACs less evidence in APS). LMWH + ASA for pregnancy.

Reference: Thrombosis Canada / ISTH APS Criteria