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The Story of the Black Swan

In 1983, a patient with features of what was to become known as the Antiphospholipid Syndrome was presented at a grand round
session at the Hammersmith Hospital in London. One of the senior physicians at the meeting after hearing the case noted that the disorder might be like the Black Swan. On hearing this description, Nigel Harris vowed to the colleague (Azzudin Gharavi) sitting next to him at the meeting that if the disorder turned out to be a real one, he would refer to it as “Syndrome of the Black Swan”.

In a few years, it was clear that the disorder was real enough, and in an editorial entitled “Syndrome of the Black Swan” in the British Journal of Rheumatology, Nigel Harris proposed the first criteria for classification of the Syndrome. These criteria were often used in the next decade for studies of patients with APS until consensus criteria based on accumulated evidence were published after the Sapporo meeting in 1998 and these were revised subsequently.

The symbol of the Black Swan was adopted by Louisville APL Diagnostics when the company was formed in the early 1990s