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Anti-phospholipid Syndrome Information
|Synonyms||LA; Lupus anticoagulant; antiphospholipid syndrome|
|Additional information||Reference: International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). Journal of Thrombosis and Haemostasis. 2006, 4:295-306.
See above reference for explicit classification criteria. This entry summarizes the classification criteria with an emphasis on the role of laboratory testing at UCSF Medical Center.
Antiphospholipid antibody syndrome (APS) is present if at least one of the clinical criteria and one of the laboratory criteria are met.
a. Vascular Thrombosis. Arterial, venous or small vessel. (Exception: superficial venous thrombosis is not a clinical criterion.)
b. Pregnancy morbidity:
i. Three or more unexplained consecutive abortions before the 10th week of gestation.
ii. One or more unexplained deaths of a morphologically normal fetus at or beyond 10th week of gestation.
iii. One or more premature births of a morphologically normal neonate before the 34th week of gestation due to eclampsia or severe pre-eclampsia or placental insufficiency.
Laboratory testing should be performed 12 weeks or more after a clinical manifestation, and is therefore not recommended at time of clinical diagnosis. Laboratory criteria are met if re-testing 12 weeks after an initial positive result demonstrates that the test is persistently positive.
a. Presence of Lupus Anticoagulant (LA).Recommended tests for assessing LA at UCSF Medical Center are the Russell Viper Venom Test (RVVTM) and the Hexagonal
Phospholipid Neutralization Test (HEXA).
b. Presence of Anticardiolipin Antibodies (aCL) of the IgG or IgM isotype at > 40 GPL and/or > 40 MPL units.Tests at UCSF Medical Center are Anti-cardiolipin Antibodies IgG (ACLG) and Anti-cardiolipin Antibodies IgM (ACLM).
c. Presence of Beta-2-glycoprotein I antibodies (anti-β2GPI) of IgG or IgM isotype. Routine testing for anti-β2GPI may not be necessary. The international consensus referenced above states that "Outside the context of clinical studies, testing for anti-β2GPI can be helpful for APS diagnosis, particularly when aCL and LA are negative and APS is strongly suspected." Tests at UCSF Medical Center for anti-β2GPI are Beta-2-glyoprotein I Antibodies IgG (B2GPG) and Beta-2-glyoprotein I Antibodies IgM (B2GPM).
|Last Updated||5/14/2010 3:22:26 PM|