Improvements in diagnosis and risk assessment of primary and secondary antiphospholipid syndrome
Open accessAbstract
Classification criteria for antiphospholipid syndrome have not been updated since the revised Sapporo classification criteria were published in 2006. These criteria have limitations in that they omit nonclassical manifestations (hematologic and neurologic), include anticardiolipin and anti-β2-glycoprotein I immunoglobulin (Ig)M isotypes, and do not separately consider primary (no autoimmune disease) or secondary (usually systemic lupus erythematosus) disease. Recent findings in antiphospholipid antibody include fluctuation of antiphospholipid antibodies, recognition that IgA isotypes do confer risk, identification of the role of complementopathy in catastrophic antiphospholipid syndrome, and elucidation of the role of thrombosis risk equations.
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LA positivity can fluctuate over time, with or without systemic lupus erythematosus, and during pregnancy it may decrease or increase.
“LA positivity may fluctuate over time with or without the presence of systemic lupus erythematosus 22,23 and during pregnancy, either decreasing or increasing.22,24,25”
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 [22]
The Introduction (page not provided), under “Limitations to current classification criteria for APS,” says antiphospholipid antibodies can fluctuate in patients with or without SLE, supporting the general fluctuation claim. It does not say that lupus anticoagulant specifically decreases or increases during pregnancy; its pregnancy discussion concerns adverse outcomes, not changes in positivity. (LLM, conf=0.85)
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Devreese, K. M. J., de Groot, P. G., de Laat, B., Erkan, D., Favaloro, E. J., Mackie, I., Martinuzzo, M., Ortel, T. L., Pengo, V., Rand, J. H., et al. (2020) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.15047 · Cited by 439 · see citing works
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- Authors
- Petri, M.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Petri, Michelle
- ORCID
- Petri, Michelle
- Venue
- Hematology
- Publisher
- American Society of Hematology
- Published
- 2019-12-06
- Volume
- 2019
- Issue
- 1
- Pages
- 415-420
- ISSN
- 1520-4383 (ISSN-L)
- 1520-4391
- PMC
- PMC6913440
- OpenAlex
- W2992382715
- Cited by
- 11
- References
- 55
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 3 · 2021: 1 · 2020: 2
- FWCI
- 0.57
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Hematology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR069572)
- 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, classification criteria, Sapporo criteria, primary antiphospholipid syndrome, secondary antiphospholipid syndrome, systemic lupus erythematosus, anticardiolipin antibodies, anti-beta2-glycoprotein I antibodies, IgA isotype, catastrophic antiphospholipid syndrome, thrombosis risk, risk assessment
- MeSH terms
- Adult, Female, Humans, Immunoglobulin A, Immunoglobulin M, Antiphospholipid Syndrome, Antibodies, Anticardiolipin, beta 2-Glycoprotein I
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