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Antiphospholipid antibodies: guidelines for determination.

R Cervera1, J Font, R A Asherson

  • 1Systemic Autoimmune Diseases Unit, Hospital Clinic, Barcelona, Catalonia, Spain, and Rheumatic Diseases Unit, Department of Medicine, University of Cape Town School of Medicine, Cape Town, South Africa.

Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases
|December 17, 2008
PubMed
Summary
This summary is machine-generated.

This review clarifies when to test for antiphospholipid antibodies (aPL) and which lab tests to use. It also suggests a work-up for seronegative antiphospholipid syndrome.

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Area of Science:

  • Clinical Immunology
  • Rheumatology
  • Laboratory Medicine

Background:

  • Antiphospholipid antibodies (aPL) are associated with thrombosis and pregnancy complications.
  • Clinical practice requires clearer guidelines on aPL testing indications and methods.

Purpose of the Study:

  • To review clinical indications for antiphospholipid antibody (aPL) testing.
  • To outline appropriate laboratory tests for aPL detection.
  • To propose a diagnostic approach for seronegative antiphospholipid syndrome.

Main Methods:

  • Literature review of clinical indications for aPL testing.
  • Summary of routine laboratory tests for aPL detection (e.g., lupus anticoagulant, anticardiolipin assays).
  • Proposal for a diagnostic work-up for suspected seronegative aPL syndrome.

Main Results:

  • Key indications for aPL testing include systemic lupus erythematosus, thrombosis, recurrent fetal loss, and autoimmune thrombocytopenia.
  • Routine tests involve syphilis serology, lupus anticoagulant assays, and solid-phase techniques for anticardiolipin and other aPL.
  • A comprehensive work-up is suggested for patients with clinical features of aPL syndrome but negative routine tests.

Conclusions:

  • Standardized guidelines are needed for aPL testing indications and laboratory selection.
  • Accurate detection of aPL is crucial for diagnosing and managing antiphospholipid syndrome.
  • A structured approach is necessary for diagnosing seronegative aPL syndrome.