Antiphospholipid antibodies: update on detection, pathophysiology, and treatment

Purpose of review The antiphospholipid syndrome is a noninflammatory disease characterized by the presence of antiphospholipid antibodies in the plasma of patients with venous or arterial thrombosis or obstetric complications. Understanding of the pathology of the syndrome is only rudimentary and no physician can pretend that treatment is adequate. It is not possible to identify patients with the syndrome for certain. This paper reviews the substantial and promising headway made in the past year. Recent findings It has become clear that lupus anticoagulant is the assay of choice to detect the syndrome and that antibodies directed towards beta(2)Glycoprotein 1 are the clinical relevant autoantibodies. These antibodies are able to activate a number of cells involved in the regulation of hemostasis. Summary The latest developments will make it soon possible to define patient with the syndrome unambiguously. This is absolutely necessary to understand why the presence of antiphospholipid antibodies cause an increased thrombotic risk.