Antiphospholipid antibody panels and recurrent pregnancy loss: prevalence of anticardiolipin antibodies compared with other antiphospholipid antibodies

Antiphospholipid antibodies are a heterogeneous group of immunoglobulins with specificity for a number of phospholipids, phospholipid-binding proteins and phospholipid-protein complexes. The association between antiphospholipid antibodies and a variety of pathologic disorders, such as arterial and venous thrombosis and recurrent pregnancy loss is recognized as Antiphospholipid Syndrome. The immunoassay currently used to detect antiphospholipid antibodies is the anticardiolipin test. Anticardiolipin antibodies are believed to be polyspecific antibodies that cross-react with all the anionic phospholipids. Therefore, testing only for anticardiolipin antibodies does not always permit detection of all antiphospholipid antibodies, specially when only IgG are evaluated. In a selected population of 74 idiopathic and secondary deep venous thrombosis patients, IgG anticardiolipin, antiphosphatidylinositol and antiphosphatidylserine antibodies were detected by solid-phase immunoassays. Our results show that by testing for each antiphospholipid family, many patients, not evidenced by the standard anticardiolipin assay, were found to be antiphospholipid-positive. The anticardiolipin positive patients have always low, moderate or high levels of antiphospholipid antibodies, suggesting that the antiphospholipid positivity is predictive of anticardiolipin positivity. It should be noted that the patients with only antiphosphatidylinositol positive antibody have a story of nervous system pathology. The meaning of these results is at present under discussion.

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The effect of low dose aspirin and low molecular weight heparin (enoxaparin) in recurrent pregnancy loss associated with antiphospholipid antibody syndrome

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174652 ◽

2017 ◽

Vol 6 (11) ◽

pp. 4830 ◽

Cited By ~ 1

Author(s):

Sasmita Swain ◽

Sujata Singh

Keyword(s):

Antiphospholipid Syndrome ◽

Live Birth ◽

Antiphospholipid Antibodies ◽

Pregnancy Loss ◽

Low Dose ◽

Recurrent Pregnancy Loss ◽

Antiphospholipid Antibody ◽

Antiphospholipid Antibody Syndrome ◽

Dose Aspirin ◽

Low Dose Aspirin

Background: Recurrent miscarriage affects 1–2% of women. Recurrent pregnancy loss (RPL) is the loss of three or more consecutive pregnancies before or during the 20th week of gestation. The most important association between gestational loss and autoimmune phenomena is the presence of antiphospholipid antibodies represented by the lupus anticoagulants and or anticardiolipin antibodies (Antiphospholipid Antibody Syndrome). The antiphospholipid syndrome is an acquired autoimmune. The clinical features are thrombosis (venous, arterial and microvascular) and/or pregnancy complications; the most prominent of which is recurrent abortion.Methods: Twenty-two selected patients during pregnancy with clinical and/or serological findings of antiphospholipid syndrome had received low dose aspirin (75 mg once daily orally) plus LMWH enoxaparin (40 mg subcutaneously/day).Results: There are live born in 86% cases compared to abortion (< 20 weeks gestational age) in 14 % cases. From 19 liveborn babies the mother having normotensive in 79% and preeclampsia 21%, 85% babies having normal growth and 15% are IUGR. 36% cases are at term (>37 weeks) and 50% cases are at preterm (<37 week) on which 9%) is spontaneous preterm and 41% is iatrogenic preterm due to preeclampsia, IUGR, PPROM and APH.Conclusions: Use of low dose aspirin (75mg) and enoxaparin 40 mg subcutaneously daily in patients with RPL due to antiphospholipid syndrome resulted in higher live birth rates. Combination treatment with aspirin and LMWH leads to a high live birth rate among women with recurrent abortion and antiphospholipid antibodies.

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Antiphospholipid antibodies other than lupus anticoagulant and anticardiolipin antibodies in women with recurrent pregnancy loss, fertile controls, and antiphospholipid syndrome

Obstetrics and Gynecology ◽

10.1016/s0029-7844(97)00065-3 ◽

1997 ◽

Vol 89 (4) ◽

pp. 549-555 ◽

Cited By ~ 93

Author(s):

D WAREBRANCH ◽

R SILVER ◽

S PIERANGELI ◽

I VANLEEUWEN ◽

E NIGELHARRIS

Keyword(s):

Antiphospholipid Syndrome ◽

Antiphospholipid Antibodies ◽

Lupus Anticoagulant ◽

Pregnancy Loss ◽

Recurrent Pregnancy Loss ◽

Anticardiolipin Antibodies

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IgA Anticardiolipin Antibodies – Relation with other Antiphospholipid Antibodies and Clinical Significance

Thrombosis and Haemostasis ◽

10.1055/s-0037-1614978 ◽

1998 ◽

Vol 79 (02) ◽

pp. 282-285 ◽

Cited By ~ 49

Author(s):

Josep Ordi-Ros ◽

Francesc Monegal-Ferran ◽

Nuria Martinez ◽

Fina Cortes-Hernandez ◽

Miquel Vilardell-Tarres ◽

...

Keyword(s):

Lupus Erythematosus ◽

Antiphospholipid Antibodies ◽

Fetal Loss ◽

Cross Sectional Study ◽

Anticardiolipin Antibodies ◽

Antiphospholipid Antibody ◽

Antiphospholipid Antibody Syndrome ◽

Serum Samples ◽

Cross Sectional ◽

Vein Thrombosis

SummaryObjective: To evaluate the usefulness of IgA antiphospholipid antibodies as markers of thrombosis and/or antiphospholipid antibody syndrome. Patients and Methods: A cross-sectional study design in a tertiary, university-based, autoimmune reference hospital. Seven-hundred ninety-five patients classified into five different groups – autoimmune diseases (255), deep vein thrombosis (153), transitory ischemic attacks (108), obstetric complications (196), infectious diseases (83) and controls (81) – were tested for IgA, IgG and IgM aPL, and lupus anticoagulant. Plasma and serum samples were drawn for detection of aPL using an internationally standardized ELISA method and LA was carried out using coagulometric assays. Results: True IgA aPL were found only in two patients with systemic lupus erythematosus; these patients were also positive to IgG aPL. Conclusion: The incidence of true positivity to IgA anticardiolipin antibodies is extremely low. Their determination was not helpful in diagnosing the antiphospholipid syndrome or in explaining thrombotic events or aPL related manifestations – fetal loss – in the groups studied.

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