Catastrophic antiphospholipid syndrome completely transformed Mark Hall’s daily life. But access to comprehensive care at U-M Health has been pivotal in treating his condition and redefining what it means to live with APS. Read Mark's story on our blog: michmed.org/JDkYV

New research shows that anticardiolipin antibodies in #AntiphospholipidSyndrome react with multiple cellular components, not just one. This may explain the diverse symptoms seen in #APS and advances understanding of its mechanisms: pmc.ncbi.nlm.nih.gov/articles/PMC12…

APS Magnet - 100% proceeds to the APS Foundation of America paypal.com/ncp/payment/Z6…

🧵 Neuro-APS: When Clots Hit the Brain Antiphospholipid Syndrome (APS) doesn’t just cause clots in the leg or lungs. Sometimes, the brain is the target. Let’s explore the neurological spectrum of APS—beyond stroke. #NeuroAPS #MedTwitter #RheumTwitter APS Foundation of America Dr Ihab Suliman

1️⃣ Stroke in the Young? Think APS. Up to 20–30% of ischemic strokes in young adults have APS as an underlying cause. 🧠 Especially if: • No classic CV risk factors • History of miscarriages or DVT • Livedo reticularis or thrombocytopenia #Stroke #Antiphospholipid

2️⃣ Transient Ischemic Attacks (TIA) Brief episodes of neurological deficit (minutes to hours) may precede major strokes. 🧪 aPL-positive patients need urgent evaluation, even if symptoms resolve. Don’t wait for the big one. #TIA #NeuroTwitter

3️⃣ Cognitive Dysfunction – A Quiet Storm Patients may present with: • Memory loss • Slowed processing • Executive dysfunction MRI: often normal or with nonspecific white matter lesions. It’s real. It’s underdiagnosed. #BrainFog #APS

4️⃣ Seizures & APS Seizures can be the presenting feature. 🧬 Proposed mechanisms: • Microthrombi • Immune-mediated neuronal injury Especially in SLE + APS overlap. Always consider aPL testing in new-onset seizures. #SeizureAwareness #Lupus #NeuroAPS

5️⃣ Migraines – Benign or aPL Clue? Refractory, vascular-type headaches—especially with aura—may be seen in APS. 🧠 Mechanisms may involve endothelial dysfunction, microthrombosis, or platelet activation. Not every migraine is APS—but some are. #Migraine #NeuroTwitter

6️⃣ Chorea – Involuntary Movements Chorea in APS is rare but striking. Often seen in: • Young women • SLE/APS overlap • Positive lupus anticoagulant MRI may be normal. Responds to immunosuppression ± anticoagulation. #Chorea #MovementDisorders

7️⃣ Transverse Myelitis Rapid-onset bilateral limb weakness, bladder/bowel dysfunction. 🧬 Often overlaps with SLE + APS. MRI spine shows cord signal changes; treat with high-dose steroids + anticoagulation. #Myelitis #NeuroEmergency

8️⃣ Sensorineural Hearing Loss (SNHL) Unexplained sudden hearing loss may be a thrombotic microvascular event in APS. Rule out other causes—but don’t forget APS in systemic autoimmunity. #SNHL #AutoimmuneHearingLoss

9️⃣ White Matter Lesions – MS Mimic? APS can cause scattered white matter changes on MRI. Key to differentiate: • History of thrombosis • Lack of oligoclonal bands • aPL positivity Mislabeling APS as MS can lead to harm. #MimicMonday #MS

🔟 Neuropsychiatric Symptoms Depression, anxiety, even psychosis have been linked to APS. Mechanisms: microvascular injury, immune effects on neurotransmission. Treat the syndrome, not just the symptoms. #Psychiatry #BrainHealth

🔚 Bottom Line: Think APS if… • Stroke/TIA in young • Seizures, migraines, cognitive decline • Neuro + history of thrombosis or pregnancy loss 🔍 Test for aPL (LAC, aCL, β2GPI) ⚠️ Always confirm on repeat at 12 weeks #Thrombosis #Neurology #Autoimmune

🧵 D-Dimer vs aPL Antibodies in APS – Risk vs Reality aPL antibodies tell you who’s at risk. D-Dimer tells you what’s happening now. Let’s break down when to use each—and how not to be misled. 👇 Dr Ihab Suliman Dr Celestino Gutiérrez González MD 🇪🇸🍏🇻🇪 APS Foundation of America APS Support UK Hemostasis Today