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.
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