SYMPTOMS CHECKLIST

The below list of symptoms devised by Professor Graham Hughes can be used as a guide to indicate whether a patient may have Hughes Syndrome. 

Each symptom has been allocated a certain number of points based on their relevance and importance. Patients may add up their own scores out of a possible 50, according to their individual symptoms, to see which bracket they fall into. This should be followed up by a professional consultation and should only be used as a rough guide. 

Points guideline: 

10/50 – Possible chance of APS

20/50 and above – Strong chance of APS 

This list is not a full anthology of the huge variety of clinical signs and symptoms that I have seen in this condition over the years. It is a rough guide only and may well be changed over the years. To be of any real value, the list and the ‘scores’ should be assessed by a group of centers and validated formally. I hope however it to be of some help to those many patients struggling to better understand the syndrome. 

Professor Graham Hughes

History

  • Family history of APS – 5 Points
  • Family history of Lupus – 3 Points 
  • DVT and pulmonary embolism – 3 Points 
  • Frequent migraines – 3 Points
  • Two or more miscarriages – 3 Points 
  • Stillbirth – 1 Point
  • Transient ischaemic attack (TIA) – 3 Points 
  • Recent memory loss – 1 Point
  • Seizures – 2 Points
  • Suspected MS – 1 Point
  • Frequent fainting – 1 Point
  • Stroke – 2 Points
  • Angina – 2 Points

Examination

  • Prominent skin liquids – 3 Points
  • Nail ‘splinter’ hemorrhages – 2 Points
  • Leg ulcers – 1 Point
  • Heart murmur – 1 Point
  • Dry ups (Schirmer Dry Eye Test) – 1 Point
  • Increased reflexes – 1 Point

 Tests

  • aPL double or triple positive – 5 Points
  • aPL weak positive – 2 Points
  • ANA > 1 in 80 or Thyroid antibodies – 1 Point
  • Platelets count range under 100,000 – 3 Points