Laboratory Evaluation of Antiphospholipid Syndrome: Is There a Role for Specific Noncriteria Antiphospholipid Antibody Tests?

被引：5
作者：
Heikal, Nahla [1 ,2 ]
Martins, Thomas B. [1 ]
White, Sandra K. [2 ]
Willis, Rohan [4 ]
Branch, D. Ware [3 ,5 ]
Schmidt, Robert L. [1 ,2 ]
Tebo, Anne E. [1 ,2 ]
机构：
[1] Univ Utah, Sch Med, ARUP Inst Clin & Expt Pathol, Salt Lake City, UT 84112 USA
[2] Univ Utah, Sch Med, Dept Pathol, Salt Lake City, UT 84112 USA
[3] Univ Utah, Sch Med, Div Maternal Fetal Med, Salt Lake City, UT USA
[4] Univ Texas Med Branch, Dept Internal Med, Div Rheumatol, Galveston, TX 77555 USA
[5] Intermt Healthcare, Salt Lake City, UT USA
来源：
AMERICAN JOURNAL OF CLINICAL PATHOLOGY | 2019年 / 152卷 / 05期
关键词：
Antiphospholipid antibodies; Antiphospholipid syndrome; Diagnostic significance; GLYCOPROTEIN I ANTIBODIES; LUPUS ANTICOAGULANT; PHOSPHATIDYLSERINE/PROTHROMBIN ANTIBODIES; RISK STRATIFICATION; ANTICARDIOLIPIN; BETA-2-GLYCOPROTEIN-I; GUIDELINES; DIAGNOSIS; UPDATE; ASSAYS;
D O I：
10.1093/ajcp/aqz085
中图分类号：
R36 [病理学];
学科分类号：
100104 ;
摘要：
Objectives: Anti-beta(2) glycoprotein I domain I (anti-domain I) and anti-phosphatidylserine/prothrombin (aPS/PT) antibodies are present in patients with antiphospholipid syndrome (APS); however, their use in evaluation remains unclear. Methods: Diagnostic attributes of lupus anticoagulant (LAC), anti-domain I IgG, anti-cardiolipin, anti-beta(2) glycoprotein I (anti-beta(2)GPI), and aPS/PT IgG and IgM antibodies were assessed in 216 patients evaluated for APS. Results: LAC had the best odds ratio (OR, 14.2) while that for anti-domain 1 IgG was comparable to anti-beta(2)GPI IgG (OR, 8.3 vs 9.4) but higher than all others. Significant correlations were observed for thrombosis (P = .03) and pregnancy-related morbidity (P = .001) with anti-domain IgG and for any thrombosis with aPS/PT IgG (P = .006). Use of noncriteria antiphospholipid with or without criteria markers did not significantly increase the probability to diagnose APS. Conclusions: Noncriteria tests can contribute to diagnosis and stratification of APS but do not improve diagnostic yield. Optimal strategies for implementation require prospective investigation.
引用
收藏
页码：638 / 646
页数：9
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