The clinical relevance of the IgM isotype of antiphospholipid antibodies in the vascular antiphospholipid syndrome
Abstract
Objectives Because it has been suggested that the IgM isotype of antiphospholipid (aPL) antibodies should no longer be included in the laboratory criteria for antiphospholipid syndrome (APS) classification, we assess the clinical relevance of IgM isotype of aPL in a cohort of patients with vascular APS. Patients/methods Mean age, sex, the presence of autoimmune diseases other than systemic lupus erythematosus, risk factors for thrombosis, the type/s and site/s of thromboembolic events, the levels of C3 and C4, and autoantibody profile were evaluated in a large cohort of persistently aPL positive patients fulfilling the Sydney criteria for APS. Patients with isolated IgM isotype were compared for each variable with those with any other aPL antibody combination. Results One hundred six patients were assessed; of these 55 (51.9%) had venous thromboembolism, 48 (45.3%) arterial thrombosis, and 3 (2.8%) small vessel thrombosis. Positivity to only IgM aPL made possible to classify 13 patients (12.3%) as vascular APS. In all cases the presence of IgM aPL was at medium-high titer, confirmed, and found to be stable in the time. There were four patients with retinal thrombosis (3.8%) and the prevalence of this event was significant in the isolated IgM isotype positive patients (p=0.005). Conclusions Data from this investigation give clinical value to the IgM isotype of aPL and suggest to consider aCL and anti-β2GPI of IgM class as valid laboratory criteria for APS classification, espec…
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In a previous study in our cohort, isolated positive IgM aPL at medium-high titer, stable over time, allowed to classify 13/106 (12.3%) patients as vascular APS.
“a previous study carried out in our cohort gave clinical value to IgM aPL by demonstrating that the isolated positive IgM aPL at medium-high titer, stable over time, allowed to classify 13/106 (12.3%) patients as vascular APS.”
From Insights into the 2023 ACR/EULAR antiphospholipid syndrome classification criteria: findings from a cohort of 205 patients with primary APS (2025) · cites this paper as [9]
IgM aCL and aβ2GPI are valid biomarkers for APS classification, especially when associated with each other and stable over time.
“This study suggests IgM aCL and aβ2GPI are valid biomarkers for APS classification, especially when they are associated with each other and stable over time [9].”
From Insights into the 2023 ACR/EULAR antiphospholipid syndrome classification criteria: findings from a cohort of 205 patients with primary APS (2025) · cites this paper as [9]
Four of these patients (3.8%) had retinal thrombosis, which was associated with an isolated positive IgM aPL test (P = 0.005).
“Moreover, four of these patients (3.8%) had retinal thrombosis, which was associated to an isolated positive IgM aPL test (P = 0.005) [9].”
From Insights into the 2023 ACR/EULAR antiphospholipid syndrome classification criteria: findings from a cohort of 205 patients with primary APS (2025) · cites this paper as [9]
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“According to two systematic reviews [7,8], the IgM isotype has only limited value in clinical practice because it is not associated with thrombosis.”
BackgroundInfluentialClinical course of high‐risk patients diagnosed with antiphospholipid syndrome
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Zen, M., Tonello, M., Carta, F., Calligaro, A., Favaro, M., Del Ross, T., Hulej, G., Rahmé, Z., Ruffatti, A., & Doria, A. (2025) · Rheumatology · doi:10.1093/rheumatology/keae665 · Cited by 7 · see citing works
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- Authors
- Del Ross, T., Ruffatti, A., Cuffaro, S., Tonello, M., Calligaro, A., Favaro, M., Facchinetti, M., Hoxha, A., & Punzi, L.
- Affiliations
- University of Padua (IT)
- Venue
- Thrombosis Research
- Publisher
- Elsevier BV
- Published
- 2015-11
- Volume
- 136
- Issue
- 5
- Pages
- 883-886
- ISSN
- 0049-3848 (ISSN-L)
- OpenAlex
- W1750933267
- Cited by
- 27
- References
- 10
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 5 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 3
- FWCI
- 1.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Thrombosis Research (publishedVersion)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Funders
- Università degli Studi di Padova
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Keywords
- antiphospholipid antibodies, IgM isotype, anticardiolipin antibodies, retinal thrombosis, venous thromboembolism, arterial thrombosis, thrombosis risk factors, complement levels, autoantibody profile
- MeSH terms
- Adolescent, Adult, Aged, Child, Female, Humans, Immunoglobulin M, Male, Middle Aged, Antiphospholipid Syndrome, Antibodies, Antiphospholipid, Young Adult
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