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Does seronegative obstetric APS exist? "pro" and "cons".

Fabrizio Conti1, Laura Andreoli2, Francesca Crisafulli2

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Summary
This summary is machine-generated.

Antiphospholipid Syndrome (APS) is a treatable cause of recurrent miscarriage. Identifying seronegative APS (SN-APS) patients, even without conventional antiphospholipid antibodies (aPL), is crucial for effective treatment and improved pregnancy outcomes.

Keywords:
Non-criteria antiphospholipid antibodiesObstetric antiphospholipid syndromeSeronegative obstetric antiphospholipid syndrome

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Area of Science:

  • Obstetrics and Gynecology
  • Immunology
  • Reproductive Medicine

Background:

  • Antiphospholipid Syndrome (APS) is a leading treatable cause of recurrent miscarriage.
  • Pharmacological treatment for pregnant patients with antiphospholipid antibodies (aPL) aims to prevent obstetric and maternal thrombotic complications.
  • Established obstetric APS (OAPS) treatment yields over 70-80% successful pregnancies.

Purpose of the Study:

  • To highlight the importance of identifying seronegative APS (SN-APS) patients who present with OAPS clinical manifestations but lack conventional aPL.
  • To emphasize the need for adequate therapy in SN-APS patients for a better prognosis.
  • To discuss the diagnostic utility of non-criteria aPL in SN-APS.

Main Methods:

  • Review of current treatment standards for obstetric APS (OAPS).
  • Analysis of clinical profiles comparing seropositive (SP)-APS and seronegative (SN)-APS patients.
  • Consideration of non-conventional aPL detection methods for SN-APS diagnosis.

Main Results:

  • Combined treatment improves pregnancy prognosis for both SP-OAPS and SN-OAPS patients.
  • Current standard of care enhances good pregnancy outcomes in SN-APS, comparable to confirmed APS.
  • Patients with OAPS clinical signs but negative conventional aPL may have SN-APS.

Conclusions:

  • Clinicians should consider SN-APS in patients with OAPS symptoms but negative conventional aPL tests.
  • Further research, including large prospective studies, is needed to standardize non-criteria aPL testing.
  • Accurate identification of SN-APS is essential for timely and effective therapeutic interventions.