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Antiphospholipid syndrome — RCPSC IM MCQ

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HardRheumatologyAntiphospholipid syndromeRCPSC IM

A 34-year-old woman has an unprovoked proximal DVT and two previous miscarriages at 11 and 13 weeks. Lupus anticoagulant is positive twice 12 weeks apart, anticardiolipin IgG is high, and beta-2 glycoprotein I IgG is high. She is not pregnant currently. What is the most appropriate management?

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Correct answer: E — Long-term warfarin anticoagulation after initial heparin therapy

Thrombosis with persistent triple-positive antiphospholipid antibodies establishes high-risk antiphospholipid syndrome. Warfarin is generally preferred over DOACs for secondary prevention in triple-positive APS.

Reference: Canadian rheumatology/thrombosis practice; EULAR antiphospholipid syndrome guidance