Simultaneous lupus anticoagulant and anticardiolipin assays and clinical detection of antiphospholipids

Abstract

Lupus anticoagulants and/or anticardiolipin antibodies were detected in 100 patients with autoimmune disorders, thrombosis, or pregnancy loss. Significant agreement between tests for these two antiphospholipid activities was lacking. Performing both assays is thus important in maximizing the likelihood of detecting antiphospholipids that may have clinical relevance.

Phospholipid binding of antiphospholipid antibodies and placental anticoagulant protein

“…The lupus anticoagulant (LAC), which by definition prolongs coagulation assays when mixed with normal plasma, is generally viewed as one part of the spectrum of antiphospholipid antibodies (28)(29)(30)(31). While some controversy exists as to whether LAC and anticardiolipin antibodies are identical or different antibody populations, and as to which is a more sensitive or specific predictor for clinical complications, both are clearly associated with thrombosis and fetal loss (32)(33)(34)(35).…”

The Antiphospholipid Antibody Syndrome

“…No laboratory tests exist that can definitively identify an APA as benign or pathologic, no particular correlation has been found between the disease pattern and the antibody class, and no single laboratory test has a predictive value for clinical complications (10). When evaluating patient samples for APAs, it is critical to perform both coagulation tests for LAs and immunologic tests for ACAs, because there is no significant correlation between the 2 modes of testing (31). Therefore, both assays must be performed to maximize the potential for detecting clinically relevant APAs.…”

Clinical Importance of Positive Test Results for Lupus Anticoagulant and Anticardiolipin Antibodies

“…Whether or not one type of antiphospholipid antibody (LA or aCL) is more strongly associated with clinical events has been addressed by different groups. 33,[36][37][38][39][40][41][42] However, few studies have been done in which sensitive LA assays have been compared with aCL assays and correlated with clinical history. In some studies, LA testing proved to be more specifically associated with thrombosis than aCL.…”