Profile and clinical relevance of non-criteria antiphospholipid antibodies in patients diagnosed with or highly suspected of APS.

Abstract

OBJECTIVE:

This study investigates the positivity and relevance of non-criteria antiphospholipid antibodies (aPLs) with clinical phenotypes in patients highly suspected of or diagnosed with antiphospholipid antibody syndrome (APS).

METHODS:

Outpatient cases were included from a prospectively-maintained database, and patients were grouped into APS (n = 168), seronegative APS (SNAPS, n = 9), those meeting the diagnostic criteria for clinical events without laboratory results (only event, n = 15), those that had aPLs positivity without clinical manifestations (asymptomatic APA, n = 39), and healthy controls (n = 88). Criteria aPLs results and APS-related clinical features were extracted. Sixteen non-criteria aPLs were tested and analyzed.

RESULTS:

LA, aCL, and aβ2GpI were positive in 84.5%, 61.3%, and 74.4% of APS patients, and 61.5%, 59.0%, and 74.4% of asymptomatic APA patients. In patients negative for criteria serological tests, 23 out of 24 were positive for at least 1 non-criteria aPLs. Triple-positive patients also had significantly higher tests of some aPLs in comparison with other groups. Stroke was associated with anti-phosphatidyl-inositol (aPI) IgG and anti-phosphatidyl-glycerol (aPG) IgG. Late embryonic loss correlated with aPI IgM, and premature birth/eclampsia was associated with aPI IgG and aPG IgG. There were also positive associations between heart valve lesions and anti-phosphatidylserine-prothrombin (PS/PT) IgM, APS nephropathy and anti-phosphatidyl-choline (aPC) IgG or aPS/PT IgG, and livedo reticularis and anti-phosphatidyl-ethanolamine (aPE) IgM.

CONCLUSION:

The prevalence of non-criteria aPLs differed from diagnostic biomarkers in patients diagnosed with or suspected of APS. Detection of aPLs provided additive value in the evaluation of APS-related clinical manifestations.

• Authors: Siting Li, Jiulang Zhao, Yina Bai, Jingjing Meng, Qian Wang, Xinping Tian, Mengtao Li, Xiaofeng Zeng, Chaojun Hu
• Journal: Rheumatology (Oxford, England) (Rheumatology (Oxford)) (Jun 29 2023) ISSN: 1462-0332 [Electronic] England
• PMID: 37382568 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: [email protected].