Version June 2024
This algorithm summarizes our approach to aPL testing and interpretation in a patient with suspected APS. This algorithm is not intended for use in patients who have had aPL testing done in the absence of clinically suspected APS.
APS may be suspected in patients with 1 or more otherwise unexplained thrombotic events or 1 or more specific adverse outcomes related to pregnancy (including multiple embryonic losses <10 weeks gestation, fetal death after 10 weeks gestation, or premature birth due to severe preeclampsia or placental insufficiency). Refer to UpToDate content on the clinical presentation of APS and indications for testing for aPL.aPL: antiphospholipid antibody; APS: antiphospholipid syndrome; LA: lupus anticoagulant; aCL: anticardiolipin antibodies; Ig: immunoglobulin; anti-β2-glycoprotein I (aβ2GPI): anti-beta2 glycoprotein I (anti-beta2GPI); ELISA: enzyme-linked immunosorbent assay.
* Communication with a consulting specialist and laboratory personnel is advised prior to LA testing in a patient receiving an anticoagulant and/or with an acute event.
¶ Our definition of "low titer" is a result greater than the upper limit of the reference range but <40 units (based on ELISA results) and our definition of a "moderate-to-high" aCL or aβ2GPI is ≥40 units (based on ELISA results).
Δ For patients with thrombosis who require anticoagulation, the choice of anticoagulation during the 12-week interval while awaiting the results of repeat testing is influenced by the degree of clinical suspicion for APS. Refer to UpToDate content on the approach to anticoagulation for patients with APS.
◊ Clinically relevant aPL include a positive LA, aCL IgG or IgM with a titer ≥40 units (based on ELISA results), and/or aβ2GPI IgG or IgM with a titer ≥40 units (based on ELISA results).
§ The IgG isotype of aCL and aβ2GPI has a stronger association with aPL-related clinical events compared with the IgM isotypes.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
