During a consensus meeting in Japan, 1998, a group of physicians designed criteria to qualify patients for APS research. Named for the city in which the doctors were meeting, the Sapporo Criteria has been updated in another APS meeting in Sydney, Australia, 2004. A patient must meet both clinical and laboratory criteria to be considered as an APS patient for the purpose of research.

Clinical criteria include blood clots of the arteries, veins or small vessels found in any tissue or organ. This means heart attack, stroke, pulmonary emboli, deep vein thrombosis, and many more. This can also mean miscarriages with no other explanation. Laboratory criteria include one or more positive aPL tests (anticardiolipin antibody, anti-beta-2-glycoprotein-I antibody, and/or lupus anticoagulant test). It is important to note that blood test must show positive results two or more times and must be done 12 weeks or more apart. If you meet ONE clinical criteria and ONE of the laboratory criteria, you have probably received an APS diagnosis.

Updated Saporro APS Classification Criteria

Clinical Criteria

• One or more blood clot of the arteries, veins or small vessels found in any tissue or organ OR
• Miscarriages under specific circumstances

Laboratory Criteria

• Positive Anticardiolipin OR
• Positive Anti-Beta-2-Glycoprotein-I
• Positive Lupus Anticoagulant Test

*Tests must show positive results two or more times and must be done 12 weeks or more apart.

For most, the road to an APS diagnosis is long. The answer is general found as a result of a major event such as a stroke, heart attack, or pulmonary embolism.

Antiphospholipid Syndrome (APS) is an autoimmune blood clotting disorder. Sometimes referred to as APS, APLS, Sticky Blood, Hughes Syndrome, or Antiphospholipid Antibody Syndrome, it is one of the most recently discovered autoimmune disorders.

APS is a clotting disorder; however, it is a systemic autoimmune disorder. It not only affects the blood, but it can affect any system or organ in the body. To understand APS, we must first understand some basics. 

Autoimmune is defined in Merriam-Webster Medical Dictionary as "of, relating to, or caused by antibodies or T cells that attack molecules, cells or tissue of the organism producing them." In other words,  antibodies attack your healthy cells instead of foreign bodies like viruses or bacteria. In APS, these are antiphospholipid antibodies (aPL).

Let's break this down a bit more for deeper understanding. Anti- means "against." So antiphospholipid antibodies are against phospholipid-binding plasma proteins. What is a phospholipid? Phospholipids are fatty compounds made of a phosphate and a lipid (a fat). They make up the membranous components of our cells, including the cell membrane of all living cells. The "fatty coating" of each of our cells is a double layer of phospholipids to protect the cell and essentially hold it all together. Phospholipids are found in many other components of the cells, but the cell membrane is a start in understanding.

In short, antiphospholipid antibodies recognize the phospholipid binding plasma proteins as "the enemy."

One of the most common misconceptions is that a positive blood test for the Lupus Anticoagulant (one of the tests that are used to detect aPL) means that you have "Lupus." This is not so. Most people with APS do NOT have Lupus. Lupus Anticoagulant is a misnomer. It does not indicate Systemic Lupus. It is not an anticoagulant. It is simply one of the laboratory indicators of Antiphospholipid Syndrome. 

Upon diagnosis, many wonder how they got APS. What did they do to get this? First, it is not contagious. You didn't get it from anyone, and you will not give it to anyone else. Though much is still unknown about autoimmune disorders, we do see APS in family clusters. No gene has been isolated at this time, but research is taking place now to determine if APS is genetic. Most APS patients can pinpoint a trigger that seemed to activate APS in them, such as a serious illness like infection or surgery, even extreme stress.

Antiphospholipid Syndrome does not discriminate. Though it is most commonly diagnosed in women of childbearing years, it can affect people of all ages. There are cases of children under the age of two being treated for APS related clotting events. Though not all races are affected equally, all races of people in all regions of the world are susceptible to APS.