A Young Disease: A Holistic Approach to the Treatment of Antiphospholipid Syndrome

Dr. Cervera: Fortunately, thrombocytopenia isn’t an issue when treating typical APS because platelets are rarely less than 70,000/mL. But in CAPS, platelet levels can be life-threateningly low. In those cases, first try to increase the platelets with glucocorticoids and IVIG. As soon as platelets are above 10,000–15,000, you can start low-dose heparin prophylaxis. When they reach 40,000 to 50,000, you can start full-dose anticoagulation.

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Samantha C. Shapiro, MD, is an academic rheumatologist and an affiliate faculty member of the Dell Medical School at the University of Texas at Austin. She is also a member of the ACR Insurance Subcommittee.

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