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Anticardiolipin antibodies are not a useful screening tool in a nonselected large group of patients with multiple
J Sastre-Garriga1, J C Reverter, J Font
1Unitat de Neuroimmunologia Clínica, H. Universitari Vall d'Hebron, Barcelona, Spain.
Abstract:
Recent works claiming that primary antiphospholipid syndrome (PAPS) cannot be clinically distinguished from multiple sclerosis (MS) recommend that MS patients be screened for anticardiolipin antibodies (ACA). In this study 296 randomly selected patients with MS and clinically isolated syndromes and 51 healthy controls were analyzed; ACA, anti-beta2-glycoprotein I, or antiprothrombin was found in 6 patients. No predominance of any kind of clinical manifestations and no cardinal manifestations of PAPS were found in these patients. ACA tests should be performed only when a suspicion of PAPS is raised and atypical clinical presentation for MS is found.
Insights
Screening multiple sclerosis (MS) patients for anticardiolipin antibodies (ACA) is not recommended unless primary antiphospholipid syndrome (PAPS) is suspected. This study found no significant link between MS and PAPS, advising ACA tests only for atypical cases.
Area of Science:
- Neurology
- Immunology
- Rheumatology
Background:
- Recent claims suggest primary antiphospholipid syndrome (PAPS) is clinically indistinguishable from multiple sclerosis (MS).
- This has led to recommendations for screening MS patients for anticardiolipin antibodies (ACA).
Purpose of the Study:
- To investigate the clinical and serological overlap between MS and PAPS.
- To determine the necessity of routine ACA screening in MS patients.
Main Methods:
- Analysis of 296 patients with MS or clinically isolated syndromes and 51 healthy controls.
- Testing for ACA, anti-beta2-glycoprotein I, and antiprothrombin antibodies.
Main Results:
- Antiphospholipid antibodies were detected in only 6 out of 296 MS patients.
- No specific clinical manifestations or cardinal signs of PAPS were observed in the patients with positive antibody tests.
- The prevalence of these antibodies in the MS cohort was not significantly higher than expected in the general population.
Conclusions:
- Routine screening for ACA in all MS patients is not supported by these findings.
- ACA testing should be reserved for cases where PAPS is clinically suspected.
- Atypical presentations in MS patients may warrant further investigation for underlying conditions like PAPS.
