Criteria and Non-Criteria Antiphospholipid Antibodies in Antiphospholipid Syndrome: How Strong Are They Correlated?

Caraiola, Simona; Voicu, Laura; Jurcut, Ciprian; Dima, Alina; Baicus, Cristian; Baicus, Anda; Cobilinschi, Claudia Oana; Ionescu, Razvan Adrian

doi:10.3390/biomedicines11082192

Cited by 4 publications

(1 citation statement)

References 37 publications

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“…With the development of many other non-criteria antiphospholipid antibodies that are currently available (antidomain I B2GPI IgG antibodies, IgA aCL and aB2GPI, antiphosphatidylserine/prothrombin antibodies (aPS/PT), and anti-annexin A5 antibodies), it is likely that the challenges around antiphospholipid testing and standardization are only getting more complicated. Currently, routine testing for non-criteria antibodies is not recommended as the evidence so far suggests an overlap between these antibodies and the current criteria-defined antibodies [ 33 , 34 ], but emerging data are suggesting an added value of non-criteria aPLs in improving the diagnostic accuracy in APS [ 35 , 36 ], and a role in risk stratification, especially for aPS/PT antibodies [ 18 ]. Finally, a possible significant value is described in patients with “seronegative APS” with an increase in the antibody positivity rate from 65.7% when testing for criteria aPLs only to 87.4% when non-criteria aPLs were tested [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Antiphospholipid Antibody Testing: An Audit on Testing Practices in a Public Tertiary Care Center

Mansory,

Alahwal,

Bahashwan

et al. 2023

JCM

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Background: Antiphospholipid antibodies (aPLs) are antibodies directed against cell membrane components and can be associated with clinical features or be asymptomatic. Testing and interpreting these antibodies is associated with many challenges and pitfalls in clinical practice. Objective: To review all antiphospholipid antibody testing and describe the testing practices, indications for testing and interpretation of results to infer local challenges with aPL testing and subsequently address ways to overcome those challenges. Methods: This is a retrospective analysis of all aPL testing done in a tertiary center between 2014 and 2018. Characteristics of study patients collected through chart review were described using the mean and standard deviation for continuous variables and proportion for categorical variables. Group differences were compared between patients with any aPL-positive result and those with no positive result using chi-square or Fisher’s exact test as appropriate for categorical variables and a simple regression model for numerical variables. Results: Among 414 patients undergoing aPL testing, mainly adult females, 62 (14.9%) patients had at least one positive antibody, of those, 26 (42%) had repeat testing done. Testing was mostly done for obstetric indication (107, 25.8%), with 36 patients having one or two early pregnancy losses <10 weeks as their testing indication. A total of 27 (6.5%) patients were labeled with APS/possible APS based on chart review, but on review of the testing of those patients according to classification criteria, only nine patients satisfied the criteria for APS. Conclusion: This study highlights the clinical challenges associated with aPL testing, including the controversies around indication for testing, the low rates of repeat testing to confirm persistence, and the common misinterpretation of results. Having an aPL testing profile, explicit reference ranges, results commentary, and close interaction between ordering physicians and laboratory staff might be starting points to overcome these challenges.

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Section: Discussionmentioning

confidence: 99%

Antiphospholipid Antibody Testing: An Audit on Testing Practices in a Public Tertiary Care Center

Mansory,

Alahwal,

Bahashwan

et al. 2023

JCM

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Research Progress on the Relationship between Deep Venous Thrombosis in Different Parts of the Lower Extremities and Pulmonary Embolism in Xining Area

王

2024

ACM

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Criteria and Non-Criteria Antiphospholipid Antibodies and Cancer in Patients with Involuntary Weight Loss

Caraiola,

Voicu,

Baicus

et al. 2023

JPM

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Cancer patients have higher prevalences of antiphospholipid antibodies (aPLs), occasionally associated with thrombotic events. A cross-sectional study regarding the presence of criteria (IgG/IgM anti-cardiolipin-aCL, anti-β2 glycoprotein I-aβ2GPI) and non-criteria (IgG/IgM anti-phosphatidylserine-aPS, anti-phosphatidylethanolamine-aPE, anti-prothrombin-aPT) aPLs in 146 patients with involuntary weight loss was performed. None of the patients had thrombotic events during the study. Out of the 36 cancer patients, 33 had non-hematologic malignancies. In the cancer subgroup, 60% of the patients had at least one positive aPL, with significantly more patients being positive for aβ2GPI IgG compared with the non-cancer subgroup—p = 0.03, OR = 2.23 (1.02–4.88). When evaluating the titres, aCL IgG/IgM, aβ2GPI IgG, aPE IgG, and aPS IgG had significantly higher values in cancer patients, the best cancer predictor being aβ2GPI IgG—AUC 0.642 (0.542–0.742). Gastrointestinal cancer patients were studied separately, and aCL IgM positivity was significantly higher—p = 0.008, OR = 6.69 (1.35–33.02). Both the titres of aCL IgM (p = 0.006) and aPS IgM (p = 0.03) were higher in the gastrointestinal cancer subgroup, with aCL IgM being the best predictor for gastrointestinal cancer development—AUC 0.808 (0.685–0.932). Despite criteria and non-criteria aPLs being frequent in cancer, their connection with thrombosis in these patients is probably dependent on other important risk factors and needs further research.

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Criteria and Non-Criteria Antiphospholipid Antibodies in Antiphospholipid Syndrome: How Strong Are They Correlated?

Cited by 4 publications

References 37 publications

Antiphospholipid Antibody Testing: An Audit on Testing Practices in a Public Tertiary Care Center

Antiphospholipid Antibody Testing: An Audit on Testing Practices in a Public Tertiary Care Center

Research Progress on the Relationship between Deep Venous Thrombosis in Different Parts of the Lower Extremities and Pulmonary Embolism in Xining Area

Criteria and Non-Criteria Antiphospholipid Antibodies and Cancer in Patients with Involuntary Weight Loss

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