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C-reactive protein level as a predictor of transient vs. sustained anticardiolipin antibody positivity

Orit Twito1, Tamar Reshef, Martin H Ellis

  • 1Department of Internal Medicine A, Meir Hospital, Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

European Journal of Haematology
|February 3, 2006
PubMed

Insights

High-sensitivity C-reactive protein (hs-CRP) may predict the persistence of antiphospholipid antibodies (aPL). A negative hs-CRP result at initial testing can help predict a sustained positive antiphospholipid antibody test in patients.

Area of Science:

  • Immunology
  • Rheumatology
  • Clinical Chemistry

Background:

  • Antiphospholipid syndrome (APS) is characterized by thromboembolism or pregnancy morbidity in patients with persistent antiphospholipid antibodies (aPL).
  • Distinguishing transient from sustained aPL positivity is crucial for diagnosis and management.
  • C-reactive protein (CRP) is a non-specific marker of inflammation.

Purpose of the Study:

  • To investigate if C-reactive protein (CRP) levels at the time of initial positive anticardiolipin (aCL) antibody testing predict whether the positivity is transient or sustained.
  • To evaluate the predictive value of high-sensitivity CRP (hs-CRP) for a second positive aCL test.

Main Methods:

  • Fifty-four patients with an initial positive aCL test underwent high-sensitivity CRP (hs-CRP) testing.
  • A repeat aCL antibody assay was performed 3-4 months later.
  • Positive and negative predictive values of hs-CRP for the second aCL result were calculated.

Main Results:

  • Of 54 patients, 42 had a sustained positive aCL test (aCL-2).
  • A negative hs-CRP result had an 82.5% predictive value for a sustained positive aCL-2.
  • A positive hs-CRP result predicted a negative aCL-2 in 35.7% of cases.

Conclusions:

  • High-sensitivity CRP (hs-CRP) may aid in assessing patients with positive anticardiolipin (aCL) antibody tests.
  • A negative hs-CRP result concurrently with an initial positive aCL test may assist in diagnostic and therapeutic decision-making.
  • hs-CRP could help differentiate transient from persistent aPL positivity.

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