Ljudmila Stojanovich

Ljudmila Stojanovich

Belgrade University, Serbia

Title: Diagnostic challenges in Antiphospholipid Syndrome (APS), or Hughes Syndrome


Ljudmila Stojanovich is the Scientific Director and Research Professor at the Bezhanijska Kosa, University Medical Center of Belgrade University in Serbia. Her research interests include Systemic Lupus Erythematosus (SLE), Antiphospholipid syndrome (APS) and vaccination in patients with autoimmune rheumatic diseases. She is an author of three monographs and of about 250 articles on various aspects of autoimmune rheumatic disorders, published in both international and domestic journals and in conference proceedings. She is on the Editorial Boards and Reviewer of numerous journals. She is also a Member of a number international projects, including “the European Forum on Antiphospholipid Antibodies/Catastrophic form”, “Multicenter studies antiphospholipid antibodies, infections and autoimmune diseases”. She is a Mentor to and supervises a number of Post-doctoral students. She has longstanding experience in the clinical management of patients with autoimmune rheumatic diseases, including SLE, APS and allied diseases. She is an Investigator in several clinical trials, including patients with SLE.


Antiphospholipid syndrome (APS) or Hughes syndrome is probably the most important paradigm of systemic autoimmune disease. Although APS is now a well-described difficult to diagnose entity, it took many decades to define the diagnostic criteria. The latest classification criteria for diagnosing APS are the 2006 Sapporo criteria that require the presence of at least one clinical manifestation and one positive laboratory criterion. Following the application of the Sapporo criteria, controversy arose because those criteria identify a more homogeneous group of APS patients at the expense of excluding another, a group collectively referred to as seronegative APS. The need for more guidelines regarding the detection of lupus anticoagulant is now fulfilled by the updated Scientific Standardization Committee guidelines. There are recent studies present on the most promising antibodies of this heterogeneous Antiphospholipid syndrome (APL) family. Nowadays, APS is increasingly recognized as a multisystem disease, the clinical expression of which may include (many non-criteria ARA) cardiac, neurological, hematological, cutaneous and other manifestations. Special attention should be given to secondary APS patients when they are subject to high-risk events: 7-10% of primary APS patients may go on to develop secondary APS with SLE. Despite updates of the diagnostic criteria, the diagnosis of SLE and APS remains difficult.