Question
| A. |
Pancytopenia |
| B. |
Recurrent abortions |
| C. |
Venous thrombosis |
| D. |
Pulmonary hypertension |
|
Correct Answer » A Explanation |
 |
Clinical Reasoning for the Correct Answer:
– Anti-Phospholipid Syndrome (APS) is primarily a prothrombotic disorder characterized by arterial and venous thrombosis and pregnancy morbidity.
– Pancytopenia (a reduction in red cells, white cells, and platelets) is not a typical feature of APS; it is more commonly seen in conditions with bone marrow involvement (e.g., aplastic anemia, leukemia).
– APS can be associated with thrombocytopenia but not pancytopenia, because platelet count may be low, but red and white cell lines are usually unaffected.
Why Option A is Incorrect:
– Pancytopenia is not a recognized manifestation of APS.
– Pancytopenia is classically seen in bone marrow failure syndromes or infiltrative diseases, not in APS.
Why Option B is Incorrect:
– Recurrent abortions or fetal loss after 10 weeks of gestation is a hallmark of APS due to placental thrombosis.
– Obstetric morbidity is part of the diagnostic criteria of APS (according to revised Sapporo criteria).
Why Option C is Incorrect:
– Venous thrombosis (e.g., deep vein thrombosis, pulmonary embolism) is the most frequent clinical manifestation of APS.
– APS causes a hypercoagulable state, leading to recurrent thrombotic events.
Why Option D is Incorrect:
– Pulmonary hypertension can occur in APS, often secondary to chronic pulmonary thromboembolism or microvascular thrombosis.
– It is a recognized but less common complication of APS.
High‑Yield Synopsis:
– Etiology & Pathogenesis
– APS is an autoimmune disorder characterized by antibodies against phospholipid-binding proteins.
– Common antibodies: lupus anticoagulant, anticardiolipin, and anti-β2 glycoprotein I antibodies.
– These antibodies promote thrombosis and pregnancy complications.
– Clinical Features
– Venous and arterial thromboses (DVT, stroke, myocardial infarction).
– Pregnancy morbidity: recurrent first/second trimester abortions, preeclampsia, fetal growth restriction.
– Hematologic: thrombocytopenia (mild), rarely hemolytic anemia.
– Differential Diagnoses
– Disseminated intravascular coagulation (DIC): presents with bleeding and thrombosis, but different clinical context.
– Thrombotic thrombocytopenic purpura (TTP): presents with schistocytes, fever, neurological findings.
– Systemic lupus erythematosus (SLE): APS can be primary or secondary to SLE.
