Document Detail


Thrombotic risk assessment in the antiphospholipid syndrome requires more than the quantification of lupus anticoagulants.
MedLine Citation:
PMID:  19965629     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Lupus anticoagulants (LACs) are associated with thromboembolic complications (TECs). LACs can be detected by their anticoagulant properties in thrombin generation assays, by the peak height (PH) and lag time (LT). To assess the thrombotic risk in LAC-positive patients, we have expressed the LAC activity quantitatively by PH/LT calibration curves, constructed for mixtures of monoclonal antibodies against beta2-glycoprotein I (beta2GPI) and prothrombin, spiked in normal plasma. PH/LT was determined in LAC patients, with (n = 38) and without (n = 21) TECs and converted into arbitrary LAC units. LAC titers ranged from 0 to 200 AU/mL, with 5 of 59 patients being negative. In the positive LAC titer population (54 of 59), LAC and anti-beta2GPI immunoglobulin G (IgG) titers correlated with TECs, with odds ratios of 3.54 (95% CI, 1.0-1.7) and 10.0 (95% CI, 1.98-50.6), respectively. In patients with single or combined low titers, useful predictions on thrombosis could be made only after additional measurements of soluble P-selectin and factor VII. This layered strategy yielded positive and negative predictive values, sensitivity, and specificity values approximately 90% in this subgroup. Hence, LAC and anti-beta2GPI IgG titers, when combined with selected markers of the hypercoagulable state, allow a relevant thrombotic risk assessment in nearly all patients with LACs.
Authors:
Katrien Devreese; Kathelijne Peerlinck; Marc F Hoylaerts
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-11-25
Journal Detail:
Title:  Blood     Volume:  115     ISSN:  1528-0020     ISO Abbreviation:  Blood     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-29     Completed Date:  2010-03-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  United States    
Other Details:
Languages:  eng     Pagination:  870-8     Citation Subset:  AIM; IM    
Affiliation:
Coagulation Laboratory, Department of Clinical Chemistry, Microbiology, and Immunology, Ghent University Hospital, Ghent, Belgium. katrien.devreese@uzgent.be
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibodies, Monoclonal / immunology,  pharmacology
Antibody Specificity
Antiphospholipid Syndrome* / blood,  epidemiology,  immunology
Biological Markers / blood
Blood Coagulation / immunology*
Calibration
Factor VII / metabolism
Humans
Immunoglobulin G / blood
Lupus Coagulation Inhibitor / blood*,  immunology
P-Selectin / blood
Predictive Value of Tests
Prothrombin / immunology
Risk Assessment
Risk Factors
Seroepidemiologic Studies
Thrombosis* / blood,  epidemiology,  immunology
beta 2-Glycoprotein I / immunology*
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Biological Markers; 0/Immunoglobulin G; 0/Lupus Coagulation Inhibitor; 0/P-Selectin; 0/beta 2-Glycoprotein I; 9001-25-6/Factor VII; 9001-26-7/Prothrombin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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