Pierangeli SS, Pierangeli HR

Language: Spanish
References: 73
Page: 111-124
PDF size: 1771.98 Kb.

ABSTRACT

Antiphospholipid antibodies are associated with thrombosis and pregnancy losses in patients with the antiphospholipid syndrome. Several pathogenic mechanisms have been described to explain clinical manifestations produced by antiphospholipid antibodies. This review addresses current modalities of treatment as well as an update on tests used for the confirmation of the diagnosis of antiphospholipid syndrome. The anticardiolipin test has been widely utilized by physicians since the mid-1980’s for diagnosing patients with antiphospholipid syndrome. Establishment of this diagnosis has enabled effective management of patients with recurrent thrombosis and recurrent pregnancy losses. The test was first established in 1983 as a radioimmunoassay and soon thereafter converted into an enzyme-linked immunosorbent assay (ELISA). The other test commonly used in the diagnosis of antiphosphoplipid syndrome is the lupus anticoagulant test. The anticardiolipin test by ELISA is sensitive for the diagnosis of antiphospholipid s yndrome but lacks specificity. On the other hand, the lupus anticoagulant assay, although more specific is not as sensitive as the anticardiolipin ELISA assay. More specific tests are now available such as the anti-β₂ glycoprotein I (anti-β₂GPI), the anti-prothrombin (anti-PT) assay and the APhL ELISA test that utilizes negatively charged phospholipids instead of cardiolipin to coat the plates. This article discusses in detail the clinical value of the above-mentioned tests, technical problems associated with them, the current laboratory classification criteria for diagnosis of antiphospholipid syndrome and possible new and better assays that will be available in the near future for diagnosis of antiphospholipid syndrome.

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