Triple positive antiphospholipid antibody profile in outpatients with tests for lupus anticoagulants

Paul Froom; Enas Saffuri-Elias; Orit Rozenberg; Mira Barak

doi:10.1515/cclm-2014-0571

Article

Triple positive antiphospholipid antibody profile in outpatients with tests for lupus anticoagulants

Paul Froom , Enas Saffuri-Elias , Orit Rozenberg and Mira Barak

Published/Copyright: August 7, 2014

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From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 53 Issue 1

Abstract

Background: A triple positive antiphospholipid (aPL) antibody profile [two positive serum IgG aPL antibodies along with one positive functional plasma lupus anticoagulant (LAC) test result] is associated with an increased risk for thrombosis, whereas patients with single positive test results may have little to no increased risk. The frequency of triple positivity in outpatients with various combinations of LAC test results is unclear.

Methods: We extracted from our database all LAC test results [dilute Russell viper venom times (dRVVT) and silica clotting times (SCT)] that had concomitant serum IgG aPL testing [both serum anti β₂-glycoprotein I (anti-β2GPI) and anti-cardiolipin (aCL) antibodies].

Results: There were 3195 patients without a prolonged prothrombin time. Double antibody positivity was found in 1% (31/2955) of those with normal functional LAC test results, in 16.0% (31/81) of those with a positive dRVVT, in 12.7% (10/79) of those with a positive SCT, and in 56.3% (45/80) of those with both tests positive (p<0.001). A triple positive aPL antibody profile was found in 28.3% (68/240) of those with at least one positive LAC test result.

Conclusions: We conclude that 28% of patients with elevated LAC tests have a triple positive aPL antibody profile and patients with two positive LAC tests have a higher prevalence of a triple positive profile than do those with one positive LAC test result.

Keywords: antiphospholipid antibodies; antiphospholipid syndrome; lupus coagulation inhibitor; Russell’s viper venom time; thrombophilia

Corresponding author: Prof. Paul Froom, MD, Regional Laboratory, Haifa and Western Galilee, Clalit Health Services, 47 Hatassia, Nesher, Israel, Fax: +972 4 8209052, E-mail: paulfr@clalit.org.il

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. All authors contributed significantly to the preparation of this paper. All authors contributed to the concept, the planning, the methodology, and writing of the manuscript. PF did the statistical analysis. PF is responsible for the overall content as guarantor.

Financial support: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2014-5-29

Accepted: 2014-6-27

Published Online: 2014-8-7

Published in Print: 2015-1-1

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Articles in the same Issue

https://doi.org/10.1515/cclm-2014-0571

Keywords for this article

antiphospholipid antibodies; antiphospholipid syndrome; lupus coagulation inhibitor; Russell’s viper venom time; thrombophilia