Hughes Syndrome Diagnosis

• General Diagnosis
• Blood Tests Explained
• Screening Test for Hughes' Syndrome

General Diagnosis ( Hughes Syndrome Diagnosis )

Scans showing poor blood flow in the brain
in a patient untreated Hughes' Syndrome.

The diagnosis depends on the history, the examination, and special tests. The doctor will ask about clotting problems in the past (any history of clots in the leg or lung), previous strokes or heart attacks (and whether they occurred at young ages), less specific clues such as headaches, migraine, memory loss, and confusion. Women will be questioned about past pregnancies, and whether there were any complications. They will be asked specifically about any miscarriages, and at what stage of pregnancy they occurred.

A lacy, net-like, red rash known as 'livedo reticularis' (some patients call this "corn beef skin"), is often found in antiphospholipid syndrome, particularly over the wrists and knees. A simple blood test can detect the 'antiphospholipid antibodies'. Other blood tests can check for underlying conditions, such as lupus. The doctor may also assess other risk factors for thrombosis - by measuring the patients blood pressure to rule out hypertension, checking their glucose levels to rule out diabetes and measuring cholesterol levels.

"Livedo reticularis" - the characteristic mottled appearance of skin seen in many patients with Hughes' Syndrome.

Blood Tests Explained ( Hughes Syndrome Diagnosis )

Laboratory tests are important for the diagnosis and should be considered in all patients with ‘unexplained’ thrombosis. The blood tests for Hughes Syndrome have complicated names but are essentially simple and universally available through your doctor/GP. There are two tests – anticardiolipin antibodies & the confusingly named Lupus anticoagulant.

Screening test for Hughes Syndrome ( Hughes Syndrome Diagnosis )

Of these two tests, the first is far more important and more frequently positive - but because nature can be awkward, some patients have only one or other test positive - hence the need to test for both. Having said this, we do see some patients who appear to have Hughes Syndrome in whom both tests are negative.

It is usually advisable to repeat the blood tests on more than one occasion - especially if the results are 'borderline' or 'doubtful'. One positive test for antiphospholipid antibodies does not mean that a person has Hughes Syndrome. For this reason, the test should be repeated after 6-8 weeks. A positive test on two occasions is much more important for doctors making the diagnosis than a test that is only positive once.

Tests that are only just positive and that are present on only one occasion may not be significant. This is because harmless antiphospholipid antibodies can be detected in the blood for brief periods, occasionally in association with a wide variety of conditions, including infections and certain drugs (e.g. antibiotics and certain blood pressure pills). In making the diagnosis, the patients history is often more important than the actual test results - for example, a 40 year old with a DVT and lung clot may not link it with the teenage migraine she suffered, or the two previous miscarriages.