Laboratory Diagnostics of Antiphospholipid Syndrome

Area of Science:

• Immunology
• Clinical Pathology
• Rheumatology

Background:

• Accurate diagnosis of antiphospholipid syndrome (APS) relies on detecting antiphospholipid antibodies (aPL).
• Suboptimal test standardization and lack of reference materials contribute to misdiagnoses.
• The 'triple test positivity' concept has emerged as a significant diagnostic aid.

Purpose of the Study:

• To evaluate the diagnostic utility of triple test positivity in identifying patients with antiphospholipid syndrome (APS).
• To explore the association of specific antibody profiles with clinical outcomes in APS.
• To highlight challenges in interpreting laboratory findings for APS.

Main Methods:

• Review of clinical studies focusing on patients with triple aPL positivity.
• Analysis of data concerning antibodies to domain 1 of β2-glycoprotein I.
• Examination of findings related to antibodies against phosphatidylserine/prothrombin complex.

Main Results:

• Triple aPL positivity identifies individuals at high risk for thromboembolic events and pregnancy loss.
• Triple positivity may stem from a single pathogenic antibody targeting domain 1 of β2-glycoprotein I.
• Data on single or double aPL positivity and their clinical associations remain limited.

Conclusions:

• Triple test positivity is a valuable tool for identifying high-risk APS patients.
• Further research is needed for patients with single or double aPL positivity.
• Close collaboration between laboratory and clinical specialists is crucial for optimal APS diagnosis and management.