What is your approach to a patient with positive antiphospholipid antibodies who otherwise do not meet clinical criteria for APS?

As antiphospholipid antibodies constitute a diagnostic criterion of SLE, such patients may need to be evaluated and monitored long term for both SLE and APS.

Agree with Drs. @Dr. First Last and @Dr. First Last. To expand, women who have APLAs should avoid estrogen replacement and estrogen containing contraceptives. Progestin only contraception is preferred although, I/we generally recommend avoiding third generation progestins as these may increase the risk of clotting. In terms of SLE screening, I will do an initial screen for SLE symptoms and send off a cbc, cmp and urinalysis. If these are wnl then I do not regularly evaluate for SLE, describe sym...

Agree with the above.

In addition, improving modifiable risk factors for thrombosis is key for primary prevention in these patients (obesity, lipids, smoking, hypertension). Women with the high risk Ab profiles should be advised about the risk of oral contraceptives. Patients need to be aware of their potential increased thrombosis risk if undergoing major surgeries, long trips, etc with appropriate precautions being taken (e.g. discuss AC for high risk surgery, avoiding prolonged immobility dur...