Ask the Experts - Diagnosing Antiphospholipid Syndrome
Ask the Experts - Diagnosing Antiphospholipid Syndrome
Can antiphospholipid syndrome (APS) be diagnosed without a documented thrombotic event or the recently proposed pregnancy morbidity criteria? I ask this in view of the consensus statement on preliminary classification criteria for definite APS.
The questioner poses an interesting question. This gets to the heart of the utility of laboratory tests and the need to correlate results from such tests with clinical characteristics. I presume that the question may have arisen in the context of a case; perhaps a patient who is found to have definitive laboratory evidence of APS (eg, high titer immunoglobulin G anticardiolipin antibodies, or antibodies to beta-2 glycoprotein I, or positive lupus anticoagulant testing, such as abnormal dilute Russel Viper Venom time, prolonged partial thromboplastin time that fails to correct with addition of normal serum, or positive platelet neutralization testing). If the patient has not had a clotting event, an otherwise unexplained fetal loss, or unexplained thrombocytopenia, it is difficult to establish the diagnosis of the APS, rather than just having the laboratory abnormality.
If this is an actual case, it would be interesting to know what the reasons were for checking the laboratory tests.
Can antiphospholipid syndrome (APS) be diagnosed without a documented thrombotic event or the recently proposed pregnancy morbidity criteria? I ask this in view of the consensus statement on preliminary classification criteria for definite APS.
The questioner poses an interesting question. This gets to the heart of the utility of laboratory tests and the need to correlate results from such tests with clinical characteristics. I presume that the question may have arisen in the context of a case; perhaps a patient who is found to have definitive laboratory evidence of APS (eg, high titer immunoglobulin G anticardiolipin antibodies, or antibodies to beta-2 glycoprotein I, or positive lupus anticoagulant testing, such as abnormal dilute Russel Viper Venom time, prolonged partial thromboplastin time that fails to correct with addition of normal serum, or positive platelet neutralization testing). If the patient has not had a clotting event, an otherwise unexplained fetal loss, or unexplained thrombocytopenia, it is difficult to establish the diagnosis of the APS, rather than just having the laboratory abnormality.
If this is an actual case, it would be interesting to know what the reasons were for checking the laboratory tests.
Source...