Coagulation screen is more specific than the anticardiolipin antibody ELISA in defining a thrombotic subset of lupus patients.

Derksen, R. H. W. M.; Hasselaar, P.; Blokzijl, L.; Meyling, F. H. J. Gmelig; Groot, Philip G. de

doi:10.1136/ard.47.5.364

Cited by 150 publications

(51 citation statements)

References 29 publications

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“…32 In our series, lupus anticoagulant and anticardiolipin antibodies were variably associated. In other reports dealing with systemic lupus erythematosus patients, the percentage of positive lupus anticoagulant assay in the absence of anticardiolipin antibodies varies from 0%' to 31% 33 and that of positive anticardiolipin antibody assay in the absence of lupus anticoagulant from 17%' to 73%. 34 All of these data indicate that there is a heterogeneity in the laboratory profile of patients with antiphospholipid antibodies and that a simultaneous determination of different antiphospholipid antibodies should be performed to reduce the number of falsenegative patients.…”

Section: Discussionmentioning

confidence: 87%

Lupus anticoagulant and anticardiolipin antibodies in young adults with cerebral ischemia.

Nencini

Baruffi

Abbate

et al. 1992

Stroke

181

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Background and Purpose: Our study evaluates in an unselected young population with cerebral ischemia the frequency of antiphospholipid antibodies; the relationship of antiphospholipid antibodies to conventional risk factors for and pathological mechanisms of cerebral ischemia; and the risk of recurrence of cerebral ischemia or systemic thrombotic events in patients with antiphospholipid antibodies compared with those without.Methods: We prospectively tested for antiphospholipid antibodies in 55 of 59 young (aged 15-44 years) adults consecutively examined for ischemic stroke (n=44) or transient ischemic attack ( n = l l ) . These patients underwent a complete clinical and laboratory assessment for cerebral ischemia and had a 3-year mean follow-up.Results: Ten patients (18%), all with stroke, had antiphospholipid antibodies. Antiphospholipid antibodies were significantly more frequent in women than in men (Fisher's test, p=0.014). Two patients with antiphospholipid antibodies had a new diagnosis of systemic lupus erythematosus. On angiography, none of the patients with antiphospholipid antibodies had extracranial lesions. Patients with antiphospholipid antibodies had significantly more prior cerebral events (Fisher's test, p=0.014), and, by survival analysis, higher probability of cerebral ischemic or systemic thrombotic events during follow-up than patients without (log rank test,/><0.005).Conclusions: We conclude that the prevalence of antiphospholipid antibodies is rather high in young adults with cerebral ischemia; that patients with cerebral ischemia and antiphospholipid antibodies may have unrecognized systemic lupus erythematosus; and that, among young patients with cerebral ischemia, patients with antiphospholipid antibodies constitute a subgroup at high risk of cerebral ischemic or systemic thrombotic recurrence. Prevention in this latter group may require close follow-up and treatment. (Stroke 1992;23:189-193)

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Section: Discussionmentioning

confidence: 87%

Lupus anticoagulant and anticardiolipin antibodies in young adults with cerebral ischemia.

Nencini

Baruffi

Abbate

et al. 1992

Stroke

181

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“…23 Nine IgG/IgM calibrators were used to report aCL levels as GPL or MPL units. Levels above 10 GPL or GPM units were considered positive.…”

Section: Serologic Assays To Measure Antiphospholipid Antibodiesmentioning

confidence: 99%

IgG antibodies that recognize epitope Gly40-Arg43 in domain I of β2–glycoprotein I cause LAC, and their presence correlates strongly with thrombosis

Laat

Derksen

Urbanus

et al. 2005

Blood

370

347

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“…Anticardiolipin antibodies were measured in an ELISA as described before (interassay variability, 6.9%). 22 Nine IgG/IgM calibrators were used to report anticardiolipin antibody levels as GPL or MPL units. Levels above 10 GPL or GPM units were considered positive.…”

Section: Serologic Assaysmentioning

confidence: 99%

Pathogenic anti-β2-glycoprotein I antibodies recognize domain I of β2-glycoprotein I only after a conformational change

Laat

Derksen

Lummel

et al. 2006

Blood

202

218

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Recently, we published the existence of 2 populations of anti-␤ 2 -glycoprotein I (␤ 2 -GPI) IgG antibodies. Type A antibodies recognize epitope G40-R43 in domain I of ␤ 2 -GPI and are strongly associated with thrombosis. Type B antibodies recognize other parts of ␤ 2 -GPI and are not associated with thrombosis. In this study we demonstrate that type A antibodies only recognize plasma-purified ␤ 2 -GPI when coated onto a negatively charged surface and not when coated onto a neutrally charged surface. The affinity of type B antibodies toward plasma-purified ␤ 2 -GPI was independent of the charge of the surface to which ␤ 2 -GPI was coated. Type A antibodies did not recognize plasmapurified ␤ 2 -GPI in solution, whereas they did recognize recombinant ␤ 2 -GPI both in solution and coated onto a neutrally charged plate. When the carbohydrate chains were removed from plasma-purified ␤ 2 -GPI, we found that type A antibodies did recognize the protein in solution. This supports the hypothesis that the difference in recognition of plasma-purified and recombinant ␤ 2 -GPI is caused by the difference in glycosylation and that epitope G40-R43 of plasma-purified ␤ 2 -GPI is covered by a carbohydrate chain. Type A anti-␤ 2 -GPI antibodies can only recognize this epitope when this carbohydrate chain is displaced as a result of a conformational change. This finding has major implications both for the detection of pathogenic anti-␤ 2 -GPI antibodies and the comprehension of the pathophysiology of the antiphospholipid syndrome.

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Coagulation screen is more specific than the anticardiolipin antibody ELISA in defining a thrombotic subset of lupus patients.

Cited by 150 publications

References 29 publications

Lupus anticoagulant and anticardiolipin antibodies in young adults with cerebral ischemia.

Lupus anticoagulant and anticardiolipin antibodies in young adults with cerebral ischemia.

IgG antibodies that recognize epitope Gly40-Arg43 in domain I of β2–glycoprotein I cause LAC, and their presence correlates strongly with thrombosis

Pathogenic anti-β2-glycoprotein I antibodies recognize domain I of β2-glycoprotein I only after a conformational change

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