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Does seronegative antiphospholipid syndrome really exist?

Ricard Cervera1, Fabrizio Conti, Andrea Doria

  • 1Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Catalonia, Spain.

Autoimmunity Reviews
|November 1, 2011
PubMed
Summary
This summary is machine-generated.

Seronegative antiphospholipid syndrome (APS) diagnosis is challenging for patients with APS symptoms but negative standard antibody tests. Emerging assays may help, but limited availability complicates diagnosis and management.

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Area of Science:

  • Rheumatology
  • Immunology
  • Clinical Diagnostics

Background:

  • Antiphospholipid syndrome (APS) diagnosis relies on clinical criteria and specific antiphospholipid (aPL) antibody tests.
  • Seronegative APS (SN-APS) is proposed for patients with APS symptoms but negative standard aPL tests (anti-cardiolipin, anti-β2 Glycoprotein I, lupus anticoagulant).
  • Current management and diagnostic criteria for SN-APS remain unclear, posing clinical challenges.

Purpose of the Study:

  • To review the arguments for and against the diagnosis of seronegative antiphospholipid syndrome (SN-APS).
  • To guide clinicians in evaluating patients with clinical APS manifestations but negative results in commonly available aPL tests.
  • To discuss the potential role of emerging aPL assays in improving SN-APS diagnosis.

Main Methods:

  • Literature review and critical analysis of existing evidence regarding SN-APS.
  • Discussion of diagnostic challenges, including transient or false-negative antibody results.
  • Examination of the utility and limitations of currently available and emerging antiphospholipid antibody assays.

Main Results:

  • The diagnosis of SN-APS is debated due to the lack of standardized criteria and validated assays.
  • Limited availability of advanced aPL assays in routine practice hinders definitive diagnosis.
  • Transient or false-negative antibody results and co-existing pro-thrombotic conditions complicate SN-APS diagnosis.

Conclusions:

  • Further research and development of standardized, widely available aPL assays are crucial for SN-APS diagnosis.
  • Clinicians must carefully consider clinical presentation alongside available test results when suspecting SN-APS.
  • The definition and management of SN-APS require further clarification to improve patient care.