Laboratory diagnosis of the antiphospholipid syndrome: a plethora of obstacles to overcome

Devreese, Katrien; Hoylaerts, Marc F.

doi:10.1111/j.1600-0609.2009.01243.x

Cited by 78Systemic Lupus Erythematosus ResearchBlood Coagulation and Thrombosis MechanismsVasculitis and related conditions

Laboratory diagnosis of the antiphospholipid syndrome: a plethora of obstacles to overcome

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Devreese, Katrien, Hoylaerts, Marc F.·2009·European Journal Of Haematology

DOI 10.1111/j.1600-0609.2009.01243.x

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Abstract

The antiphospholipid antibody syndrome (APS) is defined by two major elements: the presence in plasma of auto-antibodies, i.e. antiphospholipid antibodies and the occurrence of clinical features, categorised as vascular thrombosis or pregnancy morbidity. In contrast to recent reviews on the physiopathology of APS, the present review focuses on the laboratory diagnosis of APS. The original clinical and laboratory criteria that defined patients with APS were set in 1998 in the so-called Sapporo criteria. Although a revision of these criteria was published in 2006, a number of questions on the laboratory diagnosis of APS remain unresolved. The highlight in this review will therefore be on the potential and limitations of the detection of the lupus anticoagulant, as an established laboratory criterion for the diagnosis of APS. The strengths and weaknesses of the current laboratory guidelines are discussed against our current insight in the physiopathology of APS.

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LA detection relies on phospholipid-dependent coagulation tests, which make the methodology and interpretation difficult because anticoagulant therapy and acute phase proteins can interfere.
“LA detection is based on phospholipid (PL)-dependent coagulation tests, which complicate the methodology and hamper its interpretation because of interference, for instance by anticoagulant therapy and some acute phase response proteins.3,4”
From Guidance from the Scientific and Standardization Committee for lupus anticoagulant/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis (2020) · cites this paper as [4]
The “Lupus anticoagulant testing” section says LAC detection uses phospholipid-dependent coagulation assays and describes the methodology as complicated. The paper also says anticoagulant therapy can prolong these assays and produce false-positive results. The passages do not establish the claimed interference from acute-phase response proteins. (LLM, conf=0.86)
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Audrain MA, El-Kouri D, Hamidou MA, Mioche L, Ibara A, Langlois ML, Muller JY. Value of autoanti- bodies to beta(2)-glycoprotein 1 in the diagnosis of anti- phospholipid syndrome. Rheumatology 2002;41:550-3.
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Self-citation

Authors: Devreese, K., & Hoylaerts, M. F.
Affiliations: Ghent University Hospital (BE)
KU Leuven (BE)
Corresponding author: Devreese, Katrien
ORCID: Devreese, Katrien
Hoylaerts, Marc F.
Venue: European Journal Of Haematology
Publisher: Wiley
Published: 2009-06-10
Volume: 83
Issue: 1
Pages: 1-16
ISSN: 0902-4441 (ISSN-L)
1600-0609
DOI: 10.1111/j.1600-0609.2009.01243.x
OpenAlex: W2003142837
Cited by: 78
References: 123
Citations by year: 2024: 2 · 2023: 1 · 2022: 1 · 2021: 5 · 2020: 4 · 2019: 5 · 2018: 4 · 2017: 6 · 2016: 6 · 2015: 2 · 2014: 7 · 2013: 5 · 2012: 10
FWCI: 7.10
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: European Journal Of Haematology (publishedVersion)
PubMed (publishedVersion)
Ghent University Academic Bibliography (Ghent University) (submittedVersion)
Funders: Fondation Leducq
Topics: Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
Keywords: antiphospholipid syndrome, antiphospholipid antibodies, lupus anticoagulant, laboratory diagnosis, Sapporo criteria, venous thrombosis, pregnancy morbidity, diagnostic criteria, laboratory guidelines
MeSH terms: Blood Coagulation Tests, Enzyme-Linked Immunosorbent Assay, Female, Humans, Male, Pregnancy, Serologic Tests, Thrombin, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome, Antibodies, Antiphospholipid

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Laboratory diagnosis of the antiphospholipid syndrome: a plethora of obstacles to overcome

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