UCL logo

UCL Discovery

UCL home » Library Services » Electronic resources » UCL Discovery

Diagnosis of antiphospholipid syndrome in routine clinical practice.

Gardiner, C; Hills, J; Machin, SJ; Cohen, H; (2013) Diagnosis of antiphospholipid syndrome in routine clinical practice. Lupus , 22 (1) 18 - 25. 10.1177/0961203312460722. Green open access

[img] PDF
Lupus-2013-Gardiner-18-25.pdf

Download (265kB)

Abstract

The updated international consensus criteria for definite antiphospholipid syndrome (APS) are useful for scientific clinical studies. However, there remains a need for diagnostic criteria for routine clinical use. We audited the results of routine antiphospholipid antibodies (aPLs) in a cohort of 193 consecutive patients with aPL positivity-based testing for lupus anticoagulant (LA), IgG and IgM anticardiolipin (aCL) and anti-ß(2)glycoprotein-1 antibodies (aß(2)GPI). Medium/high-titre aCL/aβ(2)GPI was defined as >99th percentile. Low-titre aCL/aβ(2)GPI positivity (>95(th )< 99(th) percentile) was considered positive for obstetric but not for thrombotic APS. One hundred of the 145 patients fulfilled both clinical and laboratory criteria for definite APS. Twenty-six women with purely obstetric APS had persistent low-titre aCL and/or aβ(2)GPI. With the inclusion of these patients, 126 of the 145 patients were considered to have APS. Sixty-seven out of 126 patients were LA-negative, of whom 12 had aCL only, 37 had aβ(2)GPI only and 18 positive were for both. The omission of aCL or aβ(2)GPI testing from investigation of APS would have led to a failure to diagnose APS in 9.5% and 29.4% of patients, respectively. Our data suggest that LA, aCL and aβ(2)GPI testing are all required for the accurate diagnosis of APS and that low-titre antibodies should be included in the diagnosis of obstetric APS.

Type: Article
Title: Diagnosis of antiphospholipid syndrome in routine clinical practice.
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/0961203312460722
Publisher version: http://dx.doi.org/10.1177/0961203312460722
Language: English
Additional information: This article is distributed under the terms of the Creative Commons Attribution 3.0 License (http://www.creativecommons.org/licenses/by/3.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (http://www.uk.sagepub.com/aboutus/openaccess.htm).
Keywords: Antibodies, Anticardiolipin, Antiphospholipid Syndrome, Biological Markers, Female, Humans, Linear Models, Lupus Coagulation Inhibitor, Male, Predictive Value of Tests, Pregnancy, Pregnancy Complications, Retrospective Studies, Thrombosis, beta 2-Glycoprotein I
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Haematology
URI: http://discovery.ucl.ac.uk/id/eprint/1468253
Downloads since deposit
129Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item