Persistence of antiphospholipid antibodies over time and its association with recurrence of clinical manifestations: A longitudinal study from a single centre

Barilaro, Giuseppe; Coloma, Emmanuel; Chacur, Alejandro; Rocca, Carlo Della; Pérez-Isidro, Albert; Ruiz-Ortiz, Estíbaliz; Viñas, Odette; Penella, Dolors Tàssies; Reverter, Joan Carles; Andújar, Alícia Molina; Cervera, Ricard; Espinosa, Gerard

doi:10.1016/j.autrev.2022.103208

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…Clinically, patients with the persistent presence of aPLs are more likely to have a recurrence of clinical manifestations. Multiple aPLs positivity signi cantly enhances the possibility of persistent presence of aPLs, while isolated LAC and aCL positivity decreases the possibility of persistent aPLs [23,24]. On the contrary, our results indicated that single-positivity of aPLs is a risk factor of adverse outcomes.…”

Section: Discussionmentioning

confidence: 49%

Risk factors for adverse pregnancy outcomes in obstetric antiphospholipid syndrome

Yang

Wang

et al. 2022

Preprint

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Background: Antiphospholipid syndrome (APS) causes adverse obstetric outcomes in the affected patients. Our study aimed to investigate the risk factors for adverse pregnancy outcomes (APOs) in women with APS. Methods: This retrospective study included 143 pregnant women with APS admitted to Peking University People’s Hospital. Based on the presence of APOs, pregnant women were divided into the adverse outcomes group (n=49) and the non-adverse outcomes group (n=94). Clinical data were extracted from medical records. Univariate and multivariate logistic regression analyses were used to identify the risk factors associated with APOs. Results: We found that the low platelet count (≤50×109/L), hypertension during pregnancy, and single-positivity of antiphospholipid antibody (aPLs) were the risk factors of APOs after adjusting age, the number of prior spontaneous miscarriages, weight change during pregnancy, gestational diabetes, thrombosis, oligohydramnios, and aPLs status (model I). Of importance, hypertension during pregnancy and single-positivity of aPLs remained the risk factors for adverse outcomes, but the low platelet count (≤50×109/L) was no longer a risk factor after adding the adjustments of the time of diagnosis and treatment during pregnancy (model II). And the number of platelets increased after delivery under the treatment (87.53±49.81 vs. 65.06±41.3 vs. 52.75±20.70 vs. 110.19±55.30; p<0.05). Therefore, treatment could effectively decrease the risk of adverse outcomes in pregnant APS patients with thrombocytopenia. Conclusion: APS increases the risk of adverse outcomes during pregnancy. Thrombocytopenia, hypertension during pregnancy, and single-positivity of aPLs were the risk factors of APOs in women with APS. Treatment can significantly reduce the risk of adverse outcomes by upregulating platelet count during pregnancy in APS patients with thrombocytopenia.

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Section: Discussionmentioning

confidence: 49%

Risk factors for adverse pregnancy outcomes in obstetric antiphospholipid syndrome

Yang

Wang

et al. 2022

Preprint

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“…Among them are “first-line” aPLs such as: antibodies against phosphatidylserine/prothrombin complex (aPS/PT IgG/IgA/IgM), aβ2GPI Domain I, IgA of aβ2GPI and aCL, which are highly specific for the identification of APS patients ( 9 ). Some non-criteria aPLs can be applied as potential biomarkers to predict the risk of thrombosis in APS, such as anti-phosphatidylserine/prothrombin complex antibodies (aPS/PT IgG/IgA/IgM), phosphatidylserine antibodies (aPS IgG) and antibodies directed against phospholipids, anexin V ( 17 , 59 , 60 ). These antibodies are included in the laboratory classification criteria for the diagnosis of APS.…”

Section: Antiphospholipid Antibodies - Laboratory Markers Of Antiphos...mentioning

confidence: 99%

Antiphospholipid antibodies in patients with antiphospholipid syndrome

Dodig,

Čepelak

2024

Biochem. med. (Online)

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Graphical abstract Highlights • Antiphospholipid syndrome is a rare systemic autoimmune disease characterized by recurrent pregnancy morbidity or thrombosis in combination with the persistent presence of antiphospholipid antibodies in plasma/serum • Specialists in laboratory medicine should take responsibility for the entire analytical process, so that possible interferences are minimized, and physicians obtain reliable results of the patient’s laboratory findings in a timely manner • Due to possible problems in performing tests on aPLs for a more reliable (optimal) interpretation of laboratory findings, a close cooperation between laboratory specialists and clinical specialists is needed Antiphospholipid syndrome (APS) is a rare systemic autoimmune disease characterized by recurrent pregnancy morbidity or thrombosis in combination with the persistent presence of antiphospholipid antibodies (aPLs) in plasma/serum. Antiphospholipid antibodies are a heterogeneous, overlapping group of autoantibodies, of which anti-β2-glycoprotein I (aβ2GPI), anticardiolipin (aCL) antibodies and antibodies that prolong plasma clotting time in tests in vitro known as lupus anticoagulant (LAC) are included in the laboratory criteria for the diagnosis of APS. The presence of LAC antibodies in plasma is indirectly determined by measuring the length of coagulation in two tests - activated partial thromboplastin time (aPTT) and diluted Russell’s viper venom time (dRVVT). The concentration of aβ2GPI and aCL (immunglobulin G (IgG) and immunoglobulin M (IgM) isotypes) in serum is directly determined by solid-phase immunoassays, either by enzyme-linked immunosorbent assay (ELISA), fluoroimmunoassay (FIA), immunochemiluminescence (CLIA) or multiplex flow immunoassay (MFIA). For patient safety, it is extremely important to control all three phases of laboratory testing, i.e. preanalytical, analytical and postanalytical phase. Specialists in laboratory medicine must be aware of interferences in all three phases of laboratory testing, in order to minimize these interferences. The aim of this review was to show the current pathophysiological aspects of APS, the importance of determining aPLs-a in plasma/serum, with an emphasis on possible interferences that should be taken into account when interpreting laboratory findings.

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“…The thrombotic recurrence rate of patients with persistent antiphospholipid antibody (aPL) profile in a cohort with a median of 172.5-month follow-up was 40.2%. 1 The 10-year survival rate of APS patients is 90.7% and thrombosis is the first cause of death in APS patients, 2 so early prediction of thrombosis and intensive anticoagulation treatment are crucial.…”

Section: Introductionmentioning

confidence: 99%

Validation of three prediction models for thrombosis recurrence in antiphospholipid syndrome patients based on a prospective cohort

Zhao

Huang

et al. 2023

RMD Open

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ObjectivesTo validate the performance of the adjusted global antiphospholipid syndrome (APS) score (aGAPSS), Padua score and Caprini score to predict thrombosis recurrence in APS.MethodsConsecutive thrombotic-APS patients were included. aGAPSS, Padua and Caprini score at baseline were collected. Harrell c-index and calibration curve were used to validate the prediction models.Results362 patients were enrolled. The mean age was 36.30±13.88 years old, and 209 (57.7%) were female. Patients were followed up for a median of 2.32 years, with 32 (8.84%) venous and 21 (5.80%) arterial thrombosis. The 1-year, 3-year and 5-year thrombosis risks were 5.0%, 14.3% and 17.9%, respectively. The Harrell c-indexes of aGAPSS, Padua and Caprini score were 0.54 (95% CI 0.44 to 0.64), 0.54 (95% CI 0.46 to 0.62), and 0.50 (95%CI 0.42 to 0.58), respectively. Padua score had the best discrimination to predict venous thrombosis (Harrell c-index=0.61, 95% CI 0.53 to 0.69). aGAPSS had the best discrimination to predict arterial thrombosis (Harrell c-index=0.61, 95% CI 0.47 to 0.75). The calibrations for predicting thrombosis within 1, 3 and 5 years of the three models were suboptimal.ConclusionThe performance of aGAPSS, Padua and Caprini score to predict thrombosis recurrence in APS were suboptimal. Arterial and venous thrombosis recurrence predictors were different. New prediction models are required for venous and arterial thrombosis separately.

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Persistence of antiphospholipid antibodies over time and its association with recurrence of clinical manifestations: A longitudinal study from a single centre

Cited by 5 publications

References 26 publications

Risk factors for adverse pregnancy outcomes in obstetric antiphospholipid syndrome

Risk factors for adverse pregnancy outcomes in obstetric antiphospholipid syndrome

Antiphospholipid antibodies in patients with antiphospholipid syndrome

Validation of three prediction models for thrombosis recurrence in antiphospholipid syndrome patients based on a prospective cohort

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