Thrombotic risk assessment in the antiphospholipid syndrome requires more than the quantification of lupus anticoagulants

摘要: Lupus anticoagulants (LACs) are associated with thromboembolic complications (TECs). LACs can be detected by their anticoagulant properties in thrombin generation assays, the peak height (PH) and lag time (LT). To assess thrombotic risk LAC-positive patients, we have expressed LAC activity quantitatively PH/LT calibration curves, constructed for mixtures of monoclonal antibodies against β2-glycoprotein I (β2GPI) prothrombin, spiked normal plasma. was determined (n = 38) without 21) TECs converted into arbitrary units. titers ranged from 0 to 200 AU/mL, 5 59 patients being negative. In positive titer population (54 59), anti-β2GPI immunoglobulin G (IgG) correlated TECs, odds ratios 3.54 (95% CI, 1.0-1.7) 10.0 1.98-50.6), respectively. single or combined low titers, useful predictions on thrombosis could made only after additional measurements soluble P-selectin factor VII. This layered strategy yielded negative predictive values, sensitivity, specificity values approximately 90% this subgroup. Hence, IgG when selected markers hypercoagulable state, allow a relevant assessment nearly all LACs.