Antiphospholipid syndrome physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

Physical examination shows no pathognomonic physical findings of antiphospholipid syndrome (APS); however, abnormal features may be found on examination that are related to infarction or ischemia of the skin, viscera, or the central nervous system leading to cutaneous and neurological manifestations.

Physical Examination

Physical examination shows no pathognomonic physical findings of APS; however, abnormal features may be found on examination that are related to infarction or ischemia of the skin, viscera, or the central nervous system leading to cutaneous and neurological manifestations.

Appearance of the Patient

• Patients with APS usually appear normal.

Vital Signs

• Low-grade fever may be present in case of infectious cause of APS.

Cutaneous manifestations

Skin examination of patients with APS is usually positive for:

• Venous thromboembolism
• Livedo reticularis
• Purpura
• Superficial thrombophelibitis
• Leg ulcers
• Splinter hemorrhages
• Gangrene of the distal extremities
• Leg swelling

HEENT

Abnormal fundoscopic examination findings:

• Retinal artery occlusion findings
• Retinal vein thrombosis findings

Neck

• Neck examination of patients with APS can show lymphadenopathy.

Lungs

Pulmonary examination of patients with APS may show the following findings:

• Tachypnea in case of pulmonary embolism.

Heart

• Cardiovascular examination of patients with APS shows findings consistent with
• Heart valve disease
• Pericarditis

Abdomen

• Hepatomegaly
• Splenomegaly

• Abdominal tenderness in the lower abdominal quadrant in case of miscarriage or fetal loss.
• Rebound tenderness
• Guarding may be present

Back

• Back examination of patients with APS is usually normal.

Genitourinary

• Genitourinary examination of patients with APS is usually normal.

Neuromuscular

• Neurological exam findings consistent with stroke or transient ischemic attack.
• Migraine
• Vascular dementia
• Pre-eclampsia or eclampsia