This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Bertolaccini, M L Articles by Khamashta, M A Search for Related Content PubMed PubMed Citation Articles by Bertolaccini, M L Articles by Khamashta, M A Social Bookmarking                         What's this?

Laboratory diagnosis and management challenges in the antiphospholipid syndrome

Lupus Research Unit, The Rayne Institute, King’s College London School of Medicine at Guy’s, King’s and St Thomas’ Hospitals, St Thomas’ Hospital, London, UK, maria.bertolaccini{at}kcl.ac.uk

M A Khamashta

Lupus Research Unit, The Rayne Institute, King’s College London School of Medicine at Guy’s, King’s and St Thomas’ Hospitals, St Thomas’ Hospital, London, UK

The antiphospholipid syndrome (APS) is characterized by recurrent arterial and/or venous thrombosis and pregnancy morbidity manifested by early or late losses. Laboratory diagnosis of APS relies on the demonstration of a positive test for antiphospholipid antibodies (aPL). In clinical practice, the gold standard tests are those that detect anticardiolipin antibodies (aCL) and/or the lupus anticoagulant (LA). Although other specificities for aPL have been described their clinical utility and standardization has still to be established. Persistence of aPL positive tests must be demonstrated, and other causes and underlying factors considered. Although it is universally recognized that the routine screening tests (aCL and/or LA) might miss some cases, careful differential diagnosis and repeat testing are mandatory before the diagnosis of ‘seronegative APS’ can be made. Correct identification of patients with APS is important, because prophylactic anticoagulant therapy can prevent thrombosis from recurring, and treatment of affected women during pregnancy can improve fetal and maternal outcome.

Key Words: anticardiolipin • heparin • lupus anticoagulant • pregnancy morbidity • thrombosis • warfarin

Lupus, Vol. 15, No. 3, 172-178 (2006)
DOI: 10.1191/0961203306lu2293rr


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				Y.-H. Yang, C.-J. Chang, Y.-H. Chuang, H.-Y. Hsu, P. P. Chen, and B.-L. Chiang Identification of anti-prothrombin antibodies in the anti-phospholipid syndrome that display the prothrombinase activity Rheumatology, January 1, 2010; 49(1): 34 - 42. [Abstract] [Full Text] [PDF]

				Y.-H. Yang, D. Chien, M. Wu, J. FitzGerald, J. M. Grossman, B. H. Hahn, K.-K. Hwang, and P. P. Chen Novel Autoantibodies against the Activated Coagulation Factor IX (FIXa) in the Antiphospholipid Syndrome That Interpose the FIXa Regulation by Antithrombin J. Immunol., February 1, 2009; 182(3): 1674 - 1680. [Abstract] [Full Text] [PDF]

				H. Wu, D. J. Birmingham, B. Rovin, K. V. Hackshaw, N. Haddad, D. Haden, C.-Y. Yu, and L. A. Hebert D-Dimer Level and the Risk for Thrombosis in Systemic Lupus Erythematosus Clin. J. Am. Soc. Nephrol., November 1, 2008; 3(6): 1628 - 1636. [Abstract] [Full Text] [PDF]

				H. Gorki, V. Malinovski, and R. D.L. Stanbridge The antiphospholipid syndrome and heart valve surgery Eur. J. Cardiothorac. Surg., February 1, 2008; 33(2): 168 - 181. [Abstract] [Full Text] [PDF]

				J. J. Swigris, A. Fischer, J. Gilles, R. T. Meehan, and K. K. Brown Pulmonary and Thrombotic Manifestations of Systemic Lupus Erythematosus Chest, January 1, 2008; 133(1): 271 - 280. [Abstract] [Full Text] [PDF]

				J. Metzger, P. von Landenberg, M. Kehrel, A. Buhl, K. J. Lackner, and P. B. Luppa Biosensor Analysis of {beta}2-Glycoprotein I-Reactive Autoantibodies: Evidence for Isotype-Specific Binding and Differentiation of Pathogenic from Infection-Induced Antibodies Clin. Chem., June 1, 2007; 53(6): 1137 - 1143. [Abstract] [Full Text] [PDF]

				J. F. Smith Jr and M. L. Druzin Perinatal Implications of the Antiphospholipid Syndrome NeoReviews, May 1, 2007; 8(5): e206 - e213. [Abstract] [Full Text] [PDF]

				F Cacciapaglia, M Vadacca, G Coppolino, F Buzzulini, A Rigon, D Zennaro, E Zardi, and A Afeltra Spontaneous splenorenal shunt in a patient with antiphospholipid syndrome: the first case reported Lupus, January 1, 2007; 16(1): 56 - 58. [Abstract] [PDF]