Influence of different IgG anticardiolipin antibody cut‐off values on antiphospholipid syndrome classification
Open accessAbstract
Background While medium to high titers of anticardiolipin (aCL) antibodies, defined as >40 GPL units or >99th percentile, is a laboratory criteria for the 'definite' diagnosis of antiphospholipid syndrome (APS), agreement between the two cut-offs has not been validated.Objective To validate the current aCL laboratory criterion by verifying the effect of the two cut-offs on APS classification.Patients/methods Ninety aCL positive APS patients were selected on the basis of their GPL values above the 99th percentile (17.4 GPL), which was calculated by testing 100 age- and sex-matched healthy subjects.Results A significant difference in the IgG positivity (P < 0.0001) was found between the APS laboratory profiles as 20 out of the 24 (83.3%) patients with single positivity (aCL alone), six out of the 23 (26.1%) with double positivity (aCL plus lupus anticoagulant or anti-beta(2)glycoprotein I), and none out of the 43 with triple positivity (aCL plus lupus anticoagulant and anti-beta(2)glycoprotein I) had titers between the 99th percentile and 40 GPL units. Moreover, the rate of aCL values between the 99th percentile and 40 GPL units was significantly higher (P < 0.0001) in patients with pregnancy morbidity (73.7%) as compared to those with vascular thrombosis (16.9%) and those with both conditions (16.7%).Conclusion The 99th percentile cut-off level seems more sensitive than the >40 GPL value for APS classification, as it includes subjects with aCL positivity alone as well as patients with pregnancy morbidity.
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The authors' earlier work found that 40 GPL units, rather than the 99th percentile, is a valid cut-off for identifying thrombosis risk.
“We also recently observed that 40 units GPL rather than the 99th percentile is a valid cut-off to identify patients at risk of thrombosis [24].”
From Clinical course of high‐risk patients diagnosed with antiphospholipid syndrome (2010) · cites this paper as [24]
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- Authors
- RUFFATTI, A., OLIVIERI, S., TONELLO, M., BORTOLATI, M., BISON, E., SALVAN, E., FACCHINETTI, M., & PENGO, V.
- Affiliations
- University of Padua (IT)
- Corresponding author
- RUFFATTI, A.
- Venue
- Journal of Thrombosis and Haemostasis
- Publisher
- Elsevier BV
- Published
- 2008-10
- Volume
- 6
- Issue
- 10
- Pages
- 1693-1696
- ISSN
- 1538-7836 (ISSN-L)
- OpenAlex
- W1977057127
- Cited by
- 134
- References
- 24
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 10 · 2020: 7 · 2019: 9 · 2018: 14 · 2017: 6 · 2016: 12 · 2015: 12 · 2014: 8 · 2013: 6 · 2012: 16
- FWCI
- 3.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thrombosis and Haemostasis (publishedVersion)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion, other-oa)
- 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 syndrome, anticardiolipin antibodies, IgG, cut-off values, 99th percentile, anti-beta2-glycoprotein I antibodies, lupus anticoagulant, pregnancy morbidity, thrombosis, diagnostic sensitivity
- MeSH terms
- Antibodies, Monoclonal, Female, Humans, Immunoglobulin G, Male, Pregnancy, Pregnancy Complications, Sensitivity and Specificity, Thrombosis, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome, Antibodies, Anticardiolipin, Practice Guidelines as Topic, Clinical Laboratory Techniques, beta 2-Glycoprotein I
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