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Clinical Rheumatology

, Volume 26, Issue 10, pp 1663–1670 | Cite as

Specificity and sensitivity of anti-β2-glycoprotein I as compared with anticardiolipin antibody and lupus anticoagulant in Thai systemic lupus erythematosus patients with clinical features of antiphospholipid syndrome

  • Virunya Parkpian
  • Oravan Verasertniyom
  • Monchand Vanichapuntu
  • Kitti Totemchokchyakarn
  • Kanokrat Nantiruj
  • Prapaporn Pisitkul
  • Pantep Angchaisuksiri
  • Napaporn Archararit
  • Bupha Rachakom
  • Katcharin Ayurachai
  • Suchela JanwityanujitEmail author
Original Article

Abstract

Antibodies to β2-glycoprotein I (anti-β2-GPI) have been reported to have stronger association with clinical antiphospholipid syndrome (APS) than anticardiolipin antibodies (aCL) and lupus anticoagulant (LAC). We investigated the sensitivity and specificity of ELISA for anti-β2-GPI in Thai systemic lupus erythematosus (SLE) patients with clinical features of APS and compared the results with IgG/IgM aCL and LAC to find the test with the best association. The hospital records of 151 Thai SLE patients whose sera had been sent for either IgG/IgM anticardiolipin antibodies or lupus anticoagulant testing were reviewed. Sera of patients either without complete clinical records or those with APS-related manifestations other than vascular thrombosis and pregnancy morbidity (according to the international consensus statement on preliminary classification criteria for definite APS) were excluded. For the remaining subjects (112 patients), their sera were tested for anti-β2-GPI antibody, IgG and IgM anticardiolipin, and lupus anticoagulant. The sensitivity and specificity of each method were compared by using the chi-square test. Among the 112 (74.2%) SLE patients in the study, 35 (31.3%) presented with preliminary clinical criteria for APS (i.e., vascular thrombosis and pregnancy morbidity) whereas 77 (68.7%) did not. The sensitivity and specificity of anti-β2-GPI determination were 57.1 and 79.2%, respectively, whereas those of IgG aCL were 25.7 and 94.8%, of IgM aCL were 5.7 and 98.7%, and of LAC were 44.8 and 77.3%, respectively. The accuracy of the four tests showed similar association with clinical APS (accuracy of test = 72.3, 73.2, 69.6, and 68.3%, respectively). Concerning the sensitivity, specificity, and difficulty of the methods, the combination of anti-β2-GPI and IgG aCL tests was the best for the diagnosis of APS in Thai SLE patients.

Keywords

Anti-β2-glycoprotein I Anticardiolipin Antiphospholipid syndrome Lupus anticoagulant Systemic lupus erythematosus 

Notes

Acknowledgment

We are grateful to Ms. Umaporn Udomsubpayakul for her help on this statistical analysis. This study was supported by a research grant from the Faculty of Medicine, Ramathibodi Hospital, Mahidol University, no. 14/2003.

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Copyright information

© Clinical Rheumatology 2007

Authors and Affiliations

  • Virunya Parkpian
    • 1
  • Oravan Verasertniyom
    • 2
  • Monchand Vanichapuntu
    • 2
  • Kitti Totemchokchyakarn
    • 1
  • Kanokrat Nantiruj
    • 1
  • Prapaporn Pisitkul
    • 1
  • Pantep Angchaisuksiri
    • 3
  • Napaporn Archararit
    • 2
  • Bupha Rachakom
    • 2
  • Katcharin Ayurachai
    • 2
  • Suchela Janwityanujit
    • 1
    • 4
    Email author
  1. 1.Division of Allergy, Immunology and RheumatologyRamathibodi Hospital, Mahidol UniversityBangkokThailand
  2. 2.Research Center, Faculty of MedicineRamathibodi Hospital, Mahidol UniversityBangkokThailand
  3. 3.Division of Hematology, Department of MedicineRamathibodi Hospital, Mahidol UniversityBangkokThailand
  4. 4.Department of Medicine, Faculty of MedicineRamathibodi Hospital, Mahidol UniversityBangkokThailand

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