What is Hughes Syndrome?
Hughes Syndrome, described in 1983, is also known as the 'anti-phospholipid syndrome' (APS). It is also commonly referred to as ‘sticky blood’.
In summary, the blood has an increased tendency to clot, or to 'sludge'. This, in turn makes the circulation less efficient, so depriving vital organs of oxygen.
Think of heart angina... In this situation, oxygen supply to the heart (most often due to narrowing or clotting of the coronary artery) is important. The heart muscle's response is chest pain – especially when more oxygen is required, e.g. during exercise.
The onset may be sudden, e.g. a leg thrombosis (or DVT), or gradual (e.g. with migraine headaches going back over many years). In women the first presentation can be with miscarriage.
As distinct from other clotting disorders, Hughes Syndrome can affect arteries (e.g. angina, stroke) as well as veins.
All age groups can be affected, from infancy to old age. However, the majority of patients are aged between 15 and 50. Females seem to outnumber males (though there may be a "selection bias" due to their link with pregnancy loss).
The clinical history is important. A long history of migraine, for example, sometimes a history of suspected thrombosis, or in women, a history of previous miscarriages. Examination may reveal a blotchy, purplish pattern on the skin - so called livedo (or 'corned beef skin' as one of my patients called it).
The family history often turns up with a history of other "auto-immune" illnesses such as thyroid, MS, lupus, or even Hughes syndrome.
Blood testing is vital in a search for "anti-phospholipid" antibodies. Once there was one test. Then there were two. Now there are three tests. The doctor should tick the box for all three tests, as one or more may prove negative.