Confirmation of initial antiphospholipid antibody positivity depends on the antiphospholipid antibody profile
Open accessAbstract
Background The revised classification criteria for the antiphospholipid syndrome state that antiphospholipid (aPL) antibodies (lupus anticoagulant [LAC] and/or anticardiolipin [aCL] and/or anti-β2 -glycoprotein I [aβ2 GPI] antibodies) should be detected on two or more occasions at least 12 weeks apart. Consequently, classification of patient risk and adequacy of treatment may be deferred by 3 months.Objectives In order to early classify patient risk, we evaluated whether aPL positivity confirmation is related to aPL antibody profiles.Patients and methods Consecutive patients referred to our center who were initially positive in one or more tests exploring the presence of aPL were tested after 3 months. During a 4-year period, 225 patients were initially positive in one or more tests, and 161 were available for confirmation after 3 months. Patients were classified as triple-positive (n = 54: LAC(+) , aCL(+) , aβ2 GPI(+) , same isotype), double-positive (n = 50: LAC(-) , aCL(+) , aβ2 GPI(+) , same isotype) and single-positive (n = 53: LAC or aCL or aβ2 GPI antibodies as the sole positive test).Results Among subjects with triple positivity at initial testing, 98% (53 of 54) had their aPL profile confirmed after 12 weeks. The double-positive and single-positive groups had data confirmed in 42 of 50 (84%) and 23 of 57 (40%) subjects, respectively.Conclusions Our results show that high-risk subjects with triple-positive aPL profiles are identified early, at the time of the initial screening tests.
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Since most triple-positive patients remain triple positive, their confirmation appears predictable without a 12-week retest.
“Confirmation of triple-positive patients (same isotype 81 or independent of isotype of aCL and aβ2GPI 80 ) seems to be predictable without the need to retest after 12 weeks because triplepositivity persists in the majority of patients.80,81”
Persistence of LAC in triple-positive patients is very high (up to 100% of patients), and single LAC positives remain positive after 12 weeks in 40% of patients.
“persistence of LAC in triple-positive patients is very high (up to 100%ofpatients,alsosingleLACpositivesremainpositiveafter 12 weeks in 40% of patients). 21”
From Clinical Relevance of Isolated Lupus Anticoagulant Positivity in Patients with Thrombotic Antiphospholipid Syndrome (2021) · cites this paper as [21]
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- Authors
- Pengo, V., Ruffatti, A., Del Ross, T., Tonello, M., Cuffaro, S., Hoxha, A., Banzato, A., Bison, E., Denas, G., Bracco, A., & Padayattil Jose, S.
- Affiliations
- University of Padua (IT)
- Corresponding author
- Pengo, V.
- Venue
- Journal of Thrombosis and Haemostasis
- Publisher
- Elsevier BV
- Published
- 2013-08
- Volume
- 11
- Issue
- 8
- Pages
- 1527-1531
- ISSN
- 1538-7836 (ISSN-L)
- OpenAlex
- W2142444723
- Cited by
- 101
- References
- 21
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 6 · 2023: 6 · 2022: 14 · 2021: 7 · 2020: 17 · 2019: 7 · 2018: 8 · 2017: 4 · 2016: 8 · 2015: 10 · 2014: 7 · 2013: 2
- FWCI
- 7.36
- 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)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Keywords
- antiphospholipid syndrome, antiphospholipid antibodies, lupus anticoagulant, anticardiolipin antibodies, anti-beta2-glycoprotein I antibodies, antibody isotypes, antibody profiles, risk stratification, confirmatory testing
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Risk, Thrombosis, Time Factors, Reproducibility of Results, Cohort Studies, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome, Antibodies, Antiphospholipid, Antibodies, Anticardiolipin, beta 2-Glycoprotein I
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