Antiphospholipid Syndrome in the Elderly: Caution

Ten years after its identification, thousands of articlesand 2 books have made the APS popular. Subse-quently, the diagnosis of a possible APS is now frequently considered in daily practice, not only by subspe-cialists but also by general practitioners, in patients with thrombosis, sometimes whatever their age at the time of the first vascular event. We wish to emphasize here the potential hazards associated with a diagnosis of APS in elderly patients. Historically, APS was first identified as a subset of patients with SLE because of the strong association observed in this disorder between the occurrence of thrombosis, either arterial or venous, and/or miscarriages and the presence of aPL (ie, Lupus anticoagulant) and/or aCL. Later, APS was also recognized in patients who had no features of SLE, leading to the concept of a “primary APS.”1 A set of criteria has been proposed to discriminate primary from SLE-related APS.2