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Diagnosis of antiphospholipid syndrome in routine clinical practice.
- Source :
- Lupus; Jan2013, Vol. 22 Issue 1, p18-25, 8p, 2 Diagrams, 1 Chart, 3 Graphs
- Publication Year :
- 2013
-
Abstract
- The updated international consensus criteria for definite antiphospholipid syndrome (APS) are useful for scientific clinical studies. However, there remains a need for diagnostic criteria for routine clinical use. We audited the results of routine antiphospholipid antibodies (aPLs) in a cohort of 193 consecutive patients with aPL positivity-based testing for lupus anticoagulant (LA), IgG and IgM anticardiolipin (aCL) and anti-ß2glycoprotein-1 antibodies (aß2GPI). Medium/high-titre aCL/aβ2GPI was defined as >99th percentile. Low-titre aCL/aβ2GPI positivity (>95th < 99th percentile) was considered positive for obstetric but not for thrombotic APS. One hundred of the 145 patients fulfilled both clinical and laboratory criteria for definite APS. Twenty-six women with purely obstetric APS had persistent low-titre aCL and/or aβ2GPI. With the inclusion of these patients, 126 of the 145 patients were considered to have APS. Sixty-seven out of 126 patients were LA-negative, of whom 12 had aCL only, 37 had aβ2GPI only and 18 positive were for both. The omission of aCL or aβ2GPI testing from investigation of APS would have led to a failure to diagnose APS in 9.5% and 29.4% of patients, respectively. Our data suggest that LA, aCL and aβ2GPI testing are all required for the accurate diagnosis of APS and that low-titre antibodies should be included in the diagnosis of obstetric APS. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09612033
- Volume :
- 22
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Lupus
- Publication Type :
- Academic Journal
- Accession number :
- 84490576
- Full Text :
- https://doi.org/10.1177/0961203312460722