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J Thromb Haemost. 2013 Aug;11(8):1527-31. doi: 10.1111/jth.12264.

Confirmation of initial antiphospholipid antibody positivity depends on the antiphospholipid antibody profile.

Author information

1
Clinical Cardiology, Thrombosis Center, Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy. vittorio.pengo@unipd.it

Abstract

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.

KEYWORDS:

cardiolipin; glycoprotein I; lupus anticoagulant; phospholipid; thrombosis; β2

PMID:
23601766
DOI:
10.1111/jth.12264
[Indexed for MEDLINE]
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