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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

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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.

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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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Authors and Affiliations

  1. Division of Allergy, Immunology and Rheumatology, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand

    Virunya Parkpian, Kitti Totemchokchyakarn, Kanokrat Nantiruj, Prapaporn Pisitkul & Suchela Janwityanujit

  2. Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand

    Oravan Verasertniyom, Monchand Vanichapuntu, Napaporn Archararit, Bupha Rachakom & Katcharin Ayurachai

  3. Division of Hematology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand

    Pantep Angchaisuksiri

  4. Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Rajthevee, Bangkok, 10400, Thailand

    Suchela Janwityanujit

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  1. Virunya Parkpian
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Correspondence to Suchela Janwityanujit.

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Parkpian, V., Verasertniyom, O., Vanichapuntu, M. et al. 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. Clin Rheumatol 26, 1663–1670 (2007). https://doi.org/10.1007/s10067-007-0566-5

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