Margaret Wislowska
Centralny Szpital Kliniczny MSW, Poland
Title: Antiphospholipid antibody syndrome
Biography
Biography: Margaret Wislowska
Abstract
Antiphospholipid syndrome [APS] is the autoimmune disease characterized by vascular thromboses and/or pregnancy loss associated with persistently positive antiphospholipid antibodies (aPL; measured with lupus anticoagulant [LA] test, anticardiolipin antibody [aCL] enzyme-linked immunosorbent assay [ELISA], and/or anti-beta2-glycoprotein-I antibody [alfabeta2GPI] ELISA). Determining significant APS depends on: persistent (at least 12 weeks apart) aPL positivity excluding transient aPL positivity which is common during infections; 2/ a positive LA test is a better predictor of aPL-related thrombotic events compared with other aPL tests; 3/ the specificity of aCL and alfabeta2GPI ELISA tests for aPL-related clinical events increases with higher titers; 4/ 50% of the APS patients with thrombosis present with at least one non-aPL thrombosis risk factor at the time of their vascular event; 5/ IgM isotype is lesse commonly associated with clinical events compared with IgG isotype; 6/ in patients with aPL-related clinical events and no other thrombosis risk factors and have IgAaCL and IgAalfabeta2GPI positivity; 7/triple aPL positivity (LA, aCL, and alfabeta2GPI) can be clinically more significant than double or single aPL positivity. Clinical manifestation related to aPL represent a spectrum: 1/ aPL positivity without clinical events; 2/ aPL positivity solely with non – criteria manifestations (e.g. thrombocytopenia, hemolytic anemia, cardiac valve disease, aPL nephropathy); 3/ APL based on arterial / venous thrombosis and/or pregnancy morbidity; 4/ catastrophic antiphospholipid syndrome.
