Manuscript handled by: M. Levi.
Confirmation of initial antiphospholipid antibody positivity depends on the antiphospholipid antibody profile
Article first published online: 14 AUG 2013
© 2013 International Society on Thrombosis and Haemostasis
Journal of Thrombosis and Haemostasis
Volume 11, Issue 8, pages 1527–1531, August 2013
How to Cite
Confirmation of initial antiphospholipid antibody positivity depends on the antiphospholipid antibody profile. J Thromb Haemost 2013; 11: 1527–32., , , , , , , , , , .
Final decision: F. R. Rosendaal, 13 April 2013.
- Issue published online: 14 AUG 2013
- Article first published online: 14 AUG 2013
- Accepted manuscript online: 19 APR 2013 07:09AM EST
- Manuscript Received: 9 FEB 2013
- glycoprotein I;
- lupus anticoagulant;
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 [aβ2GPI] 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.
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+, aβ2GPI+, same isotype), double-positive (n = 50: LAC–, aCL+, aβ2GPI+, same isotype) and single-positive (n = 53: LAC or aCL or aβ2GPI antibodies as the sole positive test).
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.
Our results show that high-risk subjects with triple-positive aPL profiles are identified early, at the time of the initial screening tests.