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Cited by 131Systemic Lupus Erythematosus ResearchVasculitis and related conditionsBlood Coagulation and Thrombosis Mechanisms

The DOI matches its Crossref record; 42 of the 43 references it cites were found in a registry or an index.

Diagnosis of antiphospholipid syndrome in routine clinical practice

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Gardiner, C, Hills, J, Machin, SJ, Cohen, H·2013·Lupus
DOI 10.1177/0961203312460722PMC PMC4108293
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Abstract

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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Figure 1 Flowchart showing patient selection according to Sydney clinical criteria for APS.
Figure 1 Flowchart showing patient selection according to Sydney clinical criteria for APS.CC BY · PubMed Central
Figure 2 Distribution of antiphospholipid positivity in 126 patients with antiphospholipid syndrome as detailed in Figure 1.
Figure 2 Distribution of antiphospholipid positivity in 126 patients with antiphospholipid syndrome as detailed in Figure 1.CC BY · PubMed Central
Figure 3 Anticardiolipin (aCL) results by clinical history. Pregnancy morbidity (n = 40), Thrombosis (n = 105, including 14 with both thrombosis and pregnancy morbidity). All aCL values above the 95th percentile are shown. Horizontal bars represent the median titres.
Figure 3 Anticardiolipin (aCL) results by clinical history. Pregnancy morbidity (n = 40), Thrombosis (n = 105, including 14 with both thrombosis and pregnancy morbidity). All aCL values above the 95th percentile are shown. Horizontal bars represent the median titres.CC BY · PubMed Central
Figure 4 anti-β2glycoprotein-1 (aβ2GPI) results by clinical history. Pregnancy morbidity (n = 40), thrombosis (n = 105, including 14 with both thrombosis and pregnancy morbidity). All aβ2GPI values above the 95th percentile are shown. Horizontal bars represent the median titres.
Figure 4 anti-β2glycoprotein-1 (aβ2GPI) results by clinical history. Pregnancy morbidity (n = 40), thrombosis (n = 105, including 14 with both thrombosis and pregnancy morbidity). All aβ2GPI values above the 95th percentile are shown. Horizontal bars represent the median titres.CC BY · PubMed Central
Figure 5 Antiphospholipid antibody results by clinical risk: low-risk antiphospholipid syndrome (APS) n = 85, high-risk APS n = 60. Horizontal bars represent the median titres.
Figure 5 Antiphospholipid antibody results by clinical risk: low-risk antiphospholipid syndrome (APS) n = 85, high-risk APS n = 60. Horizontal bars represent the median titres.CC BY · PubMed Central

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Research works printed but not linked: 3

  1. Opatrny L, 2006, J Rheumatol, 33, 2214
  2. Loizou S, 1985, Clin Exp Immunol, 62, 738
  3. Harris EN, 1987, Clin Exp Immunol, 68, 215

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Metadata

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
DOI
10.1177/0961203312460722
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
Licence
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 › Rheumatology › 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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