Antiphospholipid Syndrome (APS):The Clinical Experience – Dr. Graham Hughes

Posted on: March 18, 2019
Last Updated: October 18, 2020

Professor Graham Hughes is a Consultant Rheumatologist and the founder and editor of the international journal ‘LUPUS,’ and Head of London Lupus Centre. In 1983 he described the clotting disorder now known as Hughes Syndrome for which he received the World Rheumatology (ILAR) Research Prize in 1993.

Author Quotes

What’s the lesson from this patient [from Case Study 1]? That the orthopaedic surgeons I think are seeing this syndrome. As well as metatarsal fractures and other fractures, we see many more now than we used to think about.

You wonder, therefore, whether you might catch some of these patients with early AVN if they are aPL positive with some form of improving circulation to that end organ.

What’s this patient teaching us [from Case Study 2]? That the cardiovascular doctors are belatedly recognising the syndrome and it’s quite obvious really – if you’ve got sludging of the blood, the brain is involved and so are other organs.


Professor Hughes continues his presentation with an account of his ‘Tuesday’ general Lupus clinics and presents some case studies.

Moving on to the second case study presented, he describes the case of a 51-year old woman.

He provides data on the relationship between APS and cardiovascular disease and discusses symptoms associated with coronary syndrome, MI, angina, and atherosclerosis.

Ending this video excerpt, he describes the association between MI and APS and SLE patients, and whether atherosclerosis is a feature of APS.

Take-home Messages

  1. The metatarsal fracture appears to be a weakness in some APS patients.
  2. The heart can also be involved in APS patients with some valve disease and syndrome X.
  3. Angina is probably still under-recognized and is shown to improve with anticoagulation therapy.


Learn more

  1. Antiphospholipid Syndrome (APS) Case Files (Stroke and Thrombosis) By Prof Graham Hughes
  2. Antiphospholipid Syndrome (APS) Case Files (Gut, Tinnitus, and Migraine) – Prof Graham Hughes
  3. Antiphospholipid Syndrome (APS) Case Files (Stillbirths and Epilepsy) By Prof Graham Hughes
  4. Antiphospholipid Syndrome: 30 Years On – Dr. Graham Hughes
  5. Central Nervous System Involvement in Antiphospholipid Syndrome – Prof Graham Hughes
  6. Clues to the Diagnosis of Antiphospholipid Syndrome – Prof Graham Hughes
  7. Neuropsychiatric Lupus and The Curious Case of Molly – What Does This Case Teach Us? – Prof Hughes
  8. Pathogenesis of Neuropsychiatric Systemic Lupus Erythematosus – Prof Graham Hughes
  9. What is Lupus? – Prof Graham Hughes
  10. Prof Graham Hughes Introduces You To The World of Lupus and Antiphospholipid Syndrome – Prof Graham Hughes
  11. APS and CNS Lupus: Anticoagulation Treatment By Prof Graham Hughes
  12. Neuropsychiatric Manifestations in APS By Prof Graham Hughes
  13. Q & A session on Lupus, Hughes Syndrome and the Brain – Prof Hughes