Diagnosis of antiphospholipid syndrome in routine clinical practice
Open accessAbstract
The updated international consensus criteria for definite antiphospholipid syndrome (APS) are useful for scientific clinical studies. However, there remains a need for diagnostic criteria for routine clinical use. We audited the results of routine antiphospholipid antibodies (aPLs) in a cohort of 193 consecutive patients with aPL positivity-based testing for lupus anticoagulant (LA), IgG and IgM anticardiolipin (aCL) and anti-ß(2)glycoprotein-1 antibodies (aß(2)GPI). Medium/high-titre aCL/aβ(2)GPI was defined as >99th percentile. Low-titre aCL/aβ(2)GPI positivity (>95(th )< 99(th) percentile) was considered positive for obstetric but not for thrombotic APS. One hundred of the 145 patients fulfilled both clinical and laboratory criteria for definite APS. Twenty-six women with purely obstetric APS had persistent low-titre aCL and/or aβ(2)GPI. With the inclusion of these patients, 126 of the 145 patients were considered to have APS. Sixty-seven out of 126 patients were LA-negative, of whom 12 had aCL only, 37 had aβ(2)GPI only and 18 positive were for both. The omission of aCL or aβ(2)GPI testing from investigation of APS would have led to a failure to diagnose APS in 9.5% and 29.4% of patients, respectively. Our data suggest that LA, aCL and aβ(2)GPI testing are all required for the accurate diagnosis of APS and that low-titre antibodies should be included in the diagnosis of obstetric APS.
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LA is the best-established risk factor for clinical manifestations related to antiphospholipid syndrome.
“LA is the best-established risk factor for APS-related clinical manifestations.[5][6][7][8][9]”
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- Authors
- Gardiner, C., Hills, J., Machin, S., & Cohen, H.
- Affiliations
- University College London Hospitals NHS Foundation Trust (GB)
- Department of Haematology, University College London Hospitals NHS Foundation Trust, London
- Corresponding author
- Gardiner, C
- ORCID
- Venue
- Lupus
- Publisher
- SAGE Publications
- Published
- 2012-09-17
- Volume
- 22
- Issue
- 1
- Pages
- 18-25
- ISSN
- 0961-2033 (ISSN-L)
- 1477-0962
- PMC
- PMC4108293
- OpenAlex
- W2098834735
- Cited by
- 131
- References
- 43
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 10 · 2023: 7 · 2022: 13 · 2021: 14 · 2020: 16 · 2019: 14 · 2018: 13 · 2017: 8 · 2016: 6 · 2015: 7 · 2014: 13 · 2013: 3
- FWCI
- 5.64
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Lupus (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Wellcome Trust (GR087730)
- 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, antiphospholipid antibodies, lupus anticoagulant, anticardiolipin antibodies, anti-beta2-glycoprotein I antibodies, obstetric antiphospholipid syndrome, thrombotic antiphospholipid syndrome, diagnostic criteria, International Consensus Criteria, diagnostic accuracy
- MeSH terms
- Female, Humans, Male, Predictive Value of Tests, Pregnancy, Pregnancy Complications, Retrospective Studies, Thrombosis, Biomarkers, Linear Models, Lupus Coagulation Inhibitor, Antiphospholipid Syndrome, Antibodies, Anticardiolipin, beta 2-Glycoprotein I
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