Tratamiento del síndrome antifosfolípido
El síndrome antifosfolípido (SAF) es una trombofilia de origen autoinmune definida por la existencia de manifestaciones clínicas trombóticas (trombosis arteriales, venosas o de pequeño vaso) y/o morbilidad obstétrica (abortos de repetición, muerte fetal o prematuridad debida a preeclampsia), junto con la presencia de anticuerpos antifosfolípidos (AFL): anticoagulante lúpico (AL), anticuerpos anticardiolipina (aCL) tipo IgG o IgM y/o anticuerpos anti-B2 glicoproteina I (anti B2 GPL) IgG o IgM), a títulos significativos y repetidos, con dos determinaciones positivas separadas 12 semanas, de acuerdo con los criterios de clasificación de Sydney 2006.
Además, en el SAF pueden aparecer otras manifestaciones no incluidas en los criterios de clasificación, como cutáneas, valvulares cardíacas, renales, del sistema nervioso central o hematológicas como trombopenia y anemia hemolítica.
Por otra parte, existe una población de personas asintomáticas portadoras de AFL que se encuentran en situación de riesgo aumentada de desarrollar el síndrome en determinadas circunstancias como intervenciones quirúrgicas, inmovilización o gestación.
Por tanto, el espectro clínico del SAF es amplio y no pueden indicarse recomendaciones de tratamiento universal, sino que deben establecerse recomendaciones distintas para los diferentes subgrupos de pacientes.
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