The (non‐)sense of detecting anti‐cardiolipin and anti‐β2glycoprotein I IgM antibodies in the antiphospholipid syndrome

Autor: Katrien Devreese, Jacek Musiał, Hilde Kelchtermans, Walid Chayoua, Jean-Christophe Gris, Gary W. Moore, Philip G. de Groot, Denis Wahl, Bas de Laat
Přispěvatelé: Cardiovascular Research Institute Maastricht (CARIM), Maastricht University [Maastricht], Synapse Research Institute, Sechenov First Moscow State Medical University, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Guy's and St Thomas' Hospital [London], Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Ghent University Hospital, Biochemie, RS: Carim - B01 Blood proteins & engineering, Salvy-Córdoba, Nathalie
Jazyk: angličtina
Rok vydání: 2020
Předmět:
[SDV.MHEP.HEM] Life Sciences [q-bio]/Human health and pathology/Hematology
030204 cardiovascular system & hematology
GUIDELINES
Gastroenterology
Immunoglobulin G
Serology
MESH: Antibodies
Antiphospholipid
MESH: Pregnancy
0302 clinical medicine
Pregnancy
immunoglobulin isotypes
CLASSIFICATION CRITERIA
RISK
Lupus anticoagulant
LUPUS ANTICOAGULANT
biology
antiphospholipid antibodies
WOMEN
[SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology
Hematology
ASSOCIATION
Antiphospholipid Syndrome
Isotype
MESH: Immunoglobulin M
pregnancy morbidity
[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
3. Good health
immunoassays
beta 2-Glycoprotein I
Antibodies
Antiphospholipid
Female
Antibody
medicine.medical_specialty
Cardiolipins
INTERNATIONAL CONSENSUS STATEMENT
DIAGNOSIS
03 medical and health sciences
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Antiphospholipid syndrome
Internal medicine
MESH: Antiphospholipid Syndrome
medicine
MANAGEMENT
Humans
thrombosis
MESH: Humans
business.industry
MESH: Antibodies
Anticardiolipin
MESH: beta 2-Glycoprotein I
medicine.disease
Immunoglobulin M
Antibodies
Anticardiolipin
biology.protein
business
MESH: Female
EXTERNAL QUALITY-ASSURANCE
MESH: Cardiolipins
Zdroj: Journal of Thrombosis and Haemostasis
Journal of Thrombosis and Haemostasis, Wiley, 2020, 18 (1), pp.169-179. ⟨10.1111/jth.14633⟩
Journal of Thrombosis and Haemostasis, 18(1), 169-179. Wiley
ISSN: 1538-7836
1538-7933
DOI: 10.1111/jth.14633⟩
Popis: Background The antiphospholipid syndrome (APS) is characterized by thrombosis and/or pregnancy morbidity with the persistent presence of lupus anticoagulant (LAC), anti-cardiolipin (aCL) and/or anti-beta 2glycoprotein I (a beta 2GPI) antibodies of the immunoglobulin G/immunoglobulin M (IgG/IgM) isotype. However, the role of aCL and a beta 2GPI IgM as a serologic marker in APS is debated. Objectives We aimed to assess the diagnostic and clinical value of IgM antiphospholipid antibodies (aPL) in APS within the classification criteria. Patients/Methods Our multicenter study comprised 1008 patients, including APS patients and controls. Anti-CL and a beta 2GPI IgG and IgM antibodies were detected with four commercially available solid phase assays. Results Positivity for aCL and/or a beta 2GPI antibodies was significantly correlated with thrombosis and pregnancy morbidity, independent of the isotype and solid phase assay. Higher odds ratios were obtained for IgG compared to IgM positivity. Isolated IgM was rare in thrombotic APS, but more frequent in obstetric APS, ranging from 3.5% to 5.4% and 5.7% to 12.3%, respectively, dependent on the solid phase assay. In a multivariate logistic regression analysis of aPL, IgM positivity was found to be associated with pregnancy morbidity. However, detection of IgM was not independently associated with thrombosis. Combined positivity for LAC, IgG, and IgM was highly associated with thrombosis and pregnancy morbidity. Conclusions Our data support testing for aCL and a beta 2GPI IgM in women suspected of obstetric APS. However, no added value was found for testing IgM in patients suspected of thrombotic APS. Still, IgM aPL might be useful as a second-line test to improve thrombotic risk stratification.
Databáze: OpenAIRE
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