ABSTRACT
The antiphospholipid syndrome (APS) is defined by thrombotic and/or obstetric events
together with the presence of antiphospholipid antibodies in plasma of patients. The
original laboratory criteria of APS included lupus anticoagulants (LA) and/or IgG/IgM
anticardiolipin antibodies (aCL). They were recently updated with the addition of
IgG/IgM anti-β2 glycoprotein I antibodies (anti-β2GPI), a better definition of “medium
to high antibody titer,” and the extension to 12 weeks of the “persistence in time.”
The revised criteria represent an improvement; however, the potential overdiagnosis
of APS remains possible, thus putting patients at risk of overtreatment. To reduce
this possibility, proposals have been made to implement strict guidelines for the
performance of the LA assay, to exclude aCL measurements in their current application
from the criteria, and to limit the measurement of anti-β2GPI to the G isotype. This
should also help in simplifying the laboratory workup of patients being investigated
for APS.
KEYWORDS
Antiphospholipid syndrome - antiphospholipid antibodies - lupus anticoagulants - anti-β2
glycoprotein I antibodies - thrombosis
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Monica GalliM.D. Ph.D.
Department of Hematology, Largo Barozzi
1, 24128 Bergamo, Italy
Email: monicagalli@ospedaliriuniti.bergamo.it
