Skip to main content
SpringerLink
Log in

Laboratory Testing for the Antiphospholipid Syndrome

  • Chapter
  • First Online:
Women's Health in Autoimmune Diseases

  • 415 Accesses

Abstract

Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by thrombosis or recurrent pregnancy losses. It is a significant cause of pregnancy morbidity manifesting as recurrent miscarriages in young females of reproductive age-group. Classification criteria for definite APS are met when at least one clinical criterion, either thrombosis (arterial, venous or small vessel) or pregnancy morbidity, and one laboratory criterion (persistent positivity for Lupus anticoagulant, anticardiolipin or anti-beta 2 Glycoprotein 1 antibodies on two or more occasions at least 12 weeks apart) are present. For detection of Lupus anticoagulant, at least 2 assays- diluted Russell viper venom time and activated partial thromboplastin time based test using silica as an activator are recommended. Anticardiolipin and anti-beta 2 Glycoprotein 1 IgG/IgM antibodies are detected by enzyme linked immunosorbent assay, chemiluminescence or fluorescence enzyme immunoassay. Testing for lupus anticoagulant may be challenging while in acute phase of thrombosis and on anticoagulant therapy. Laboratory participation in external quality assurance exercises is highly recommended for standardization and inter-laboratory agreement of laboratory assays. In this chapter we discuss the key issues in APS pertaining to women with a focus on laboratory testing.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Sebastiani GD, Galeazzi M, Tincani A et al (1999) Anticardiolipin and anti-beta2GPI antibodies in a large series of European patients with systemic lupus erythematosus. Prevalence and clinical associations. European Concerted Action on the Immunogenetics of SLE. Scand J Rheumatol 28:344–351

    CAS  PubMed  Google Scholar 

  2. Soltesz P, Veres K, Lakos G, Kiss E, Muszbek L, Szegedi G (2003) Evaluation of clinical and laboratory features of antiphospholipid syndrome: a retrospective study of 637 patients. Lupus 12:302–307

    Article  CAS  Google Scholar 

  3. Love PE, Santoro SA (1990) Antiphospholipid antibodies: anticardiolipin and the lupus anticoagulant in systemic lupus erythematosus (SLE) and in non SLE disorders. Ann Int Med 112:682–698

    Article  CAS  Google Scholar 

  4. Wahl DG, Guillemin F, de Maistre E, Perret C, Lecompte T, Thibaut G (1997) Risk for venous thrombosis related to antiphospholipid antibodies in systemic lupus erythematosus—a meta-analysis. Lupus 6:467–473

    Article  CAS  Google Scholar 

  5. Franco JS, Molano-González N, Rodríguez-Jiménez M et al (2014) The coexistence of antiphospholipid syndrome and systemic lupus erythematosus in Colombians. PLoS One 9:e110242

    Article  Google Scholar 

  6. Nabriski D, Ellis M, Ness-Abramof R, Shapiro M, Shenkman L (2000) Autoimmune thyroid disease and antiphospholipid antibodies. Am J Hematol 64:73–75

    Article  CAS  Google Scholar 

  7. Rees JD, Lanca S, Marques PV et al (2006) Prevalence of antiphospholipid syndrome in primary systemic vasculitis. Ann Rheum Dis 65:109–111

    Article  CAS  Google Scholar 

  8. Fauchais AL, Lambert M, Launay D et al (2004) Antiphospholipid antibodies in primary Sjögren’s syndrome and clinical significance in a series of 74 patients. Lupus 13:245–248

    Article  CAS  Google Scholar 

  9. Hull RG, Harris EN, Gharavi AE et al (1984) Anticardiolipin antibodies: occurrence in Behcet’s syndrome. Ann Rheum Dis 43:746–748

    Article  CAS  Google Scholar 

  10. Mader R, Ziv M, Adawi M, Mader R, Lavi I (1999) Thrombophilic factors and their relation to thromboembolic and other clinical manifestations in Behçet's disease. J Rheumatol 11:2404–2408

    Google Scholar 

  11. Tokay S, Direskeneli H, Yurdakul S, Akoglu T (2001) Anticardiolipin antibodies in Behcet’s disease: a reassessment. Rheumatology (Oxford) 40:192–195

    Article  CAS  Google Scholar 

  12. Chakravarty K, Pountain G, Merry P, Byron M, Hazleman B, Scott DG (1995) A longitudinal study of anticardiolipin antibody in polymyalgia rheumatica and giant cell arteritis. J Rheumatol 22:1694–1697

    CAS  PubMed  Google Scholar 

  13. Merkel PA, Chang Y, Pierangeli SS, Convery K, Harris EN, Polisson RP (1996) The prevalence and clinical associations of anticardiolipin antibodies in a large inception cohort of patients with connective tissue diseases. Am J Med 101:576–583

    Article  CAS  Google Scholar 

  14. Di Prima FA, Valenti O, Hyseni E, Giorgio E, Faraci M, Renda E et al (2011) Antiphospholipid syndrome during pregnancy: the state of the art. J Prenat Med 5:41–53

    PubMed  PubMed Central  Google Scholar 

  15. Jaslow CR, Carney JL, Kutteh WH (2010) Diagnostic factors identified in 1020 women with two versus three or more recurrent pregnancy losses. Fertil Steril 93(4):1234–1243

    Article  CAS  Google Scholar 

  16. Kutten WH, Rote NS, Silver R (1999) Antiphospholipid antibodies and reproduction. Am J Reprod Immunol 4:13–152

    Google Scholar 

  17. Oron G, Ben-Haroush A, Goldfarb R, Molad Y, Hod M, Bar J (2011) Contribution of the addition of anti-β2-glycoprotein to the classification of antiphospholipid syndrome in predicting adverse pregnancy outcome. J Matern Fetal Neonatal Med 24:606–609

    Article  Google Scholar 

  18. Brey RL, Stallworth CL, McGlasson DL, Wozniak MA, Wityk RJ, Stern BJ et al (2002) Antiphospholipid antibodies and stroke in young women. Stroke 33:2396–2400

    Article  CAS  Google Scholar 

  19. Ulcova-Gallova Z (2014) The role of antiphospholipid antibodies (aPls) in infertile women: the long-lasting experience. Reprod Med Biol 14:49–55

    Article  Google Scholar 

  20. Forastiero R (2012) Bleeding in the antiphospholipid syndrome. Hematology 17(Suppl 1):S153–S155

    Article  CAS  Google Scholar 

  21. Lockshin MD, Kim M, Laskin CA et al (2012) Prediction of adverse pregnancy outcome by the presence of lupus anticoagulant, but not anticardiolipin antibody, in patients with antiphospholipid antibodies. Arthritis Rheum 64:2311–2318

    Article  CAS  Google Scholar 

  22. Agar C, van Os GM, Morgelin M et al (2010) Beta2-glycoprotein I can exist in 2 conformations: implications for our understanding of the antiphospholipid syndrome. Blood 116:1336–1343

    Article  CAS  Google Scholar 

  23. Arachchillage DRJ, Laffan M (2017) Pathogenesis and management of antiphospholipid syndrome. Br J Haematol 178:181–195

    Article  CAS  Google Scholar 

  24. Rand JH, Wu XX, Andree HA et al (1997) Pregnancy loss in the antiphospholipid-antibody syndrome—a possible thrombogenic mechanism. N Engl J Med 337:154–160

    Article  CAS  Google Scholar 

  25. Miyakis S, Lockshin MD, Atsumi T et al (2006) International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 4:295–306

    Article  CAS  Google Scholar 

  26. Rand JH, Wolgast LR (2012) Dos and don’ts in diagnosing antiphospholipid syndrome. Hematology Am Soc Hematol Educ Program 2012:455–459

    Article  Google Scholar 

  27. Devreese K, Hoylaerts M (2010) Challenges in the diagnosis of the antiphospholipid syndrome. Clin Chem 56:930–940

    Article  CAS  Google Scholar 

  28. An GD, Lim HH, Han JY (2017) Laboratory diagnosis of antiphospholipid syndrome. Clin Exp Thromb Hemost 3:2–7

    Article  Google Scholar 

  29. Douxfils J, Ageno W, Samama CM, Lessire S, Ten Cate H, Verhamme PJ et al (2018) Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians. Thromb Haemost 16:209–219

    Article  CAS  Google Scholar 

  30. Ahluwalia J, Sreedharanunni S, Kumar N, Masih J, Bose SK, Varma N et al (2016) Thrombotic primary antiphospholipid syndrome: the profile of antibody positivity in patients from North India. Int J Rheum Dis 19:903–912

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Jasmina Ahluwalia & Saniya Sharma

Authors
  1. Jasmina Ahluwalia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Saniya Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Internal Medicine, PGIMER, Chandigarh, India

    Shefali Khanna Sharma

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ahluwalia, J., Sharma, S. (2020). Laboratory Testing for the Antiphospholipid Syndrome. In: Sharma, S. (eds) Women's Health in Autoimmune Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-15-0114-2_5

Download citation

  • DOI: https://doi.org/10.1007/978-981-15-0114-2_5

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-0113-5

  • Online ISBN: 978-981-15-0114-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation