Hughes Syndrome (the antiphospholipid syndrome): Ten clinical lessons

The APS was described 25 years ago as a triad of manifestations (GRV Hughes). During the last 3 decades the disease became more systemic than systemic lupus erythematosus (SLE). The paper entails many of the old clinical findings as well as novel ones which are still not well documented in large series. The authors also refer to the second hit theory of infectious origin of APS. How to treat and indications for self monitoring the INR are detailed. The question of whether specific IVIG (directed against anti cardiolipin) or anti CD 20 be incorporated into the therapeutic armamentarium employed in APS will be answered in the near future.