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Cited by 89Systemic Lupus Erythematosus ResearchVasculitis and related conditionsBlood Coagulation and Thrombosis Mechanisms

The (non-)sense of detecting anti-cardiolipin and anti-β2glycoprotein I IgM antibodies in the antiphospholipid syndrome

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Chayoua, Walid, Kelchtermans, Hilde, Gris, Jean‐Christophe, Moore, Gary W., Musiał, Jacek, Wahl, Denis, de Groot, Philip G., de Laat, Bas +1 more·2020·Journal of Thrombosis and Haemostasis
DOI 10.1111/jth.14633
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Abstract

Background The antiphospholipid syndrome (APS) is characterized by thrombosis and/or pregnancy morbidity with the persistent presence of lupus anticoagulant (LAC), anti-cardiolipin (aCL) and/or anti-β2glycoprotein I (aβ2GPI) antibodies of the immunoglobulin G/immunoglobulin M (IgG/IgM) isotype. However, the role of aCL and aβ2GPI IgM as a serologic marker in APS is debated. Objectives We aimed to assess the diagnostic and clinical value of IgM antiphospholipid antibodies (aPL) in APS within the classification criteria. Patients/methods Our multicenter study comprised 1008 patients, including APS patients and controls. Anti-CL and aβ2GPI IgG and IgM antibodies were detected with four commercially available solid phase assays. Results Positivity for aCL and/or aβ2GPI antibodies was significantly correlated with thrombosis and pregnancy morbidity, independent of the isotype and solid phase assay. Higher odds ratios were obtained for IgG compared to IgM positivity. Isolated IgM was rare in thrombotic APS, but more frequent in obstetric APS, ranging from 3.5% to 5.4% and 5.7% to 12.3%, respectively, dependent on the solid phase assay. In a multivariate logistic regression analysis of aPL, IgM positivity was found to be associated with pregnancy morbidity. However, detection of IgM was not independently associated with thrombosis. Combined positivity for LAC, IgG, and IgM was highly associated with thrombosis and pregnancy morbidity. Conclusions Our data support testing for aCL and aβ2GPI IgM in women suspected of obstetric APS. However, no added value was found for testing IgM in patients suspected of thrombotic APS. Still, IgM aPL might be useful as a second-line test to improve thrombotic risk stratification.

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  • The value of IgM aCL and aβ2GPI measurement in APS is debated as there is a weaker correlation with thrombosis than with IgG isotypes and LA, although they may be valuable in the diagnosis of obstetric APS and contribute to risk stratification in the detection of triple positivity.

    “The value of IgM aCL and aβ2GPI measurement in APS is debated as there is a weaker correlation with thrombosis than with IgG isotypes and LA, although they may be valuable in the diagnosis of obstetric APS and contribute to risk stratification in the detection of triple positivity [41].”

    From Triple-positive antiphospholipid syndrome does not guarantee positivity in each lupus anticoagulant assay (2023) · cites this paper as [41]

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Authors
Chayoua, W., Kelchtermans, H., Gris, J., Moore, G. W., Musiał, J., Wahl, D., de Groot, P. G., de Laat, B., & Devreese, K. M. J.
Affiliations
  • Maastricht University Medical Centre (NL)
  • Sechenov University (RU)
  • St Thomas' Hospital (GB)
  • Jagiellonian University (PL)
  • Inserm (FR)
  • Ghent University Hospital (BE)
Corresponding author
Devreese, Katrien M.J.
ORCID
Venue
Journal of Thrombosis and Haemostasis
Publisher
Elsevier BV
Published
2020-01
Volume
18
Issue
1
Pages
169-179
ISSN
1538-7836 (ISSN-L)
DOI
10.1111/jth.14633
OpenAlex
W2972831563
Cited by
89
References
8
Citations by year
2026: 11 · 2025: 15 · 2024: 14 · 2023: 13 · 2022: 12 · 2021: 10 · 2020: 14
FWCI
6.72
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Thrombosis and Haemostasis (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, other-oa)
  • Homo Politicus (Academy of Humanities and Economics in Lodz) (submittedVersion, cc-by-nc-nd)
  • HAL (submittedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion)
  • Research Publications (Maastricht University) (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, anti-beta2-glycoprotein I antibodies, IgM, IgG, lupus anticoagulant, thrombosis, pregnancy morbidity, serological diagnosis, thrombotic risk stratification, solid-phase assay
MeSH terms
Cardiolipins, Female, Humans, Immunoglobulin M, Pregnancy, Antiphospholipid Syndrome, Antibodies, Antiphospholipid, Antibodies, Anticardiolipin, beta 2-Glycoprotein I

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