The antiphospholipid syndrome (APS) is defined by the occurrence of venous and arterial thrombosis, and pregnancy morbidity due to the presence of antiphospholipid antibodies, namely lupus anticoagulant (LA), anticardiolipin antibodies (aCL), or anti-b2-glycoprotein- I antibodies (ab2-GPI). The APS can be found in patients having neither clinical nor laboratory evidence of another definable condition (primary APS) or it may be associated with other diseases, mainly systemic lupus erythematosus (SLE). We had a female 23 years old patient with recurrent stroke, diagnosed with APS since 2010 and already had medication. Patient came with limp on left body, difficulty to walk and headache. We found PT extension (12.8 secs) and Lupus Antikoagulan 1,2 (positively weak) and Anti Nuclear Antibody (ANA) positive with titer 1/320 with homogenous pattern. From Digital Substraction Angiography (DSA) there was occlusion on left sinous transversus. In this case, secondary APS is suspected, as patient had ANA positive there was possibility that she had Systemic Lupus Eryhthematosus (SLE). But in the later examination we didnt find any other signs, symptoms and laboratory result that supported SLE. Lupus Antikoagulan (LA) showed positively weak perhaps caused by the medication, ideally before check for the LA test, patient should not consume Oral Antikoagulant for 1 week, but it can be dilematic in patient that has thrombosis symptoms due to recurrent thromboembolic complication. She later had also heparin for therapy which should be stopped before checked for LA minimum for 12 hours. In SLE patients, APS can be developed in 50%-70% patients. We could not find other signs or symptoms for SLE in this patients, even the characteristic as young female in reproductive age is suitable for SLE. The fact that she also thromboembolism that can not be explained is included in high risk criteria for APS. The extension of PT can be caused by the oral anticoagulant, but also can be due to LA itself due to hipoprothrombinemia occasionally.
Key words : APS, LA, Stroke, PT, ANA.