Naslov
Laboratory evaluation of antiphospholipid antibodies: Have the recommended guidelines for diagnosing antiphospholipid syndrome been followed

Autori
Margetić, Sandra ; Tešija Kuna, Andrea ; Vukasović, Ines ; Vrkić, Nada

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
J Thromb Haemost 2013 ; 11 (Suppl 2) - Abstracts of the XXIV Congress of the International Society on Thrombosis and Haemostasis. June 29- July 4, 2013. Amsterdam, The Netherlands / Reitsma, Pieter ; Rosendaal, Frits - Amsterdam : International Society on Thrombosis and haemostasis, 2013, 861-862

Skup
XXIV Congress of the International Society on Thrombosis and Haemostasis

Mjesto i datum
Amsterdam, Nizozemska, 29.06.2013. - 04.07.2013

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
antiphospholipid antibodies ; lupus anticoagulant ; anticardiolipin antibodies ; anti-b2-glycoprotein-1 antibodies

Sažetak
Ackground: In addition to clinical indicators, laboratory evaluationof antiphospholipid antibodies (aPLAs) is an integral part of the diag-nostic criteria for antiphospholipid syndrome (APS). Based primarilyon the method detection, there are three major subgroups of aPLAs:lupus anticoagulant (LA), anticardiolipin antibodies (ACL) and anti-b2-glycoprotein-1 antibodies (anti-b2GPI). According to the Interna-tional Society of Thrombosis and Haemostasis (ISTH) recommendedguidelines, the laboratory investigation of aPLAs should alwaysinclude determination of all three groups of antibodies.Aim: The aim of this study was to analyze the results of laboratoryevaluation of aPLAs in unselected consecutive patients who referredfor testing during 1 year period.Methods: LA antibodies were identified by a panel of commercialcoagulation assays (Siemens, Germany) including screening tests (acti-vated partial thromboplastin time (APTT, Actin FSL), APTT mixingtest, dilute Russell¢s viper venom time dRVVT screen and dRVVTconfirmation test. The laboratory evaluation of ACL and anti-b2GPIantibodies was performed using enzyme-linked immunosorbent(ELISA) assays (Orgentec, Germany) for immunoglobulin M (IgM)and immunoglobulin G (IgG) isotypes.Results: The prevalence of positive results for individual aPLAs were:LA = 33/991, 3.3% ; ACL = 67/1253, 5.3% (IgG = 22/67, 33% ; IgM = 31/67, 46% ; IgG and IgM = 14/67, 21%) and anti-b2GPI = 7/177, 4.0% (IgG 4/7 ; IgM 3/7, IgG and IgM 1/7). Only for 11/86 (13%)of all positive patients, laboratory investigation included all threegroups of aPLAs. Anti-b2GPI were ordered only for 16/86 (18.6%)patients. LA and ACL were simultaneously ordered for 48/86 (56%)of positive patients, while LA alone was ordered for 10/86 (12%)patients and ACL alone for 33/86 (38%) patients. Among 44 positivecases for simultaneously ordered LA and ACL, 15/44 (34%) werepositive for both LA and ACL, 9/44 (20%) were LA positive and ACLnegative and 20/44 (46%) were ACL positive and LA negative. Of thetotal 86 positive results, LA was ordered for 58 patients (67%) withpositivity of 57% (33/58), while ACL antibodies were ordered for 77(90%) patients with positivity of 87% (67/77). Only in 4/33 (12%) ofLA positives, 8/67 (11.9%) of ACL positives and 1/7 of anti-b2GPIpositives, laboratory evaluation was performed on two separate occa-sions at least 12 weeks apart.Conclusions: The laboratory investigation of individual aPLAs amongunselected consecutive patients had shown the prevalence of 3.3– 5.3%for individual subgroups of antibodies, with the highest prevalence ofACL antibodies. Our results indicated that laboratory investigationhas not been completely performed in accordance with the recom-mended guidelines on testing, since only for a small number of patientstesting was performed for all three subgroups of antibodies or at leastfor two (LA and ACL). Additionally, for a minority of positivepatients testing was ordered on two separate occasions at least after12 weeks. It is obvious that laboratory has to take the more substan-tial role in the investigation process of APS, than just providing doc-tors with numbers. The corrective actions should primarily includeongoing education of clinicians pointing the importance of determin- ing all three subgroups of aPLAs, since patients may be negative forone subgroup of aPLAs and positive for others.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Farmacija

POVEZANOST RADA