Abstract
In general, there are no significant differences in the cardinal clinical features of APS such as arterial or venous thrombosis or pregnancy morbidity whether the syndrome is primary or secondary to an underlying connective tissue disorder. IgM aCLs are more commonly seen in SLE than PAPS but there is no difference in thrombotic rates.
The distinction between PAPS and APS due to SLE can sometimes be difficult. In both the conditions, thrombocytopenia, anemia, renal, and central nervous system disease may be seen. Anti-dsDNA or antibodies to extractable nuclear antigens are not found in PAPS, and their presence usually suggests SLE as a secondary cause. The number of cases reported in the literature of patients with PAPS evolving into SLE is small, and some patients have developed the disease after 10 years. The presence of high titre ANA (>1:320), low complement levels, and lymphopenia may be predictive.
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References
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Bertolaccini, M.L., Ateka-Barrutia, O., Khamashta, M.A. (2010). Differences Between Primary and Secondary APS. In: Antiphospholipid Syndrome Handbook. Springer, London. https://doi.org/10.1007/978-1-84628-735-0_6
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DOI: https://doi.org/10.1007/978-1-84628-735-0_6
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