Semin Thromb Hemost 2012; 38(04): 322-327
DOI: 10.1055/s-0032-1304719
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

What Have We Learned about Antiphospholipid Syndrome from Patients and Antiphospholipid Carrier Cohorts?

Vittorio Pengo
1   Department of Cardiac, Thoracic and Vascular Sciences, Clinical Cardiology, Thrombosis Centre, University of Padova Medical School, Padova, Italy
,
Alessandra Banzato
1   Department of Cardiac, Thoracic and Vascular Sciences, Clinical Cardiology, Thrombosis Centre, University of Padova Medical School, Padova, Italy
,
Elisa Bison
1   Department of Cardiac, Thoracic and Vascular Sciences, Clinical Cardiology, Thrombosis Centre, University of Padova Medical School, Padova, Italy
,
Alessia Bracco
1   Department of Cardiac, Thoracic and Vascular Sciences, Clinical Cardiology, Thrombosis Centre, University of Padova Medical School, Padova, Italy
,
Gentian Denas
1   Department of Cardiac, Thoracic and Vascular Sciences, Clinical Cardiology, Thrombosis Centre, University of Padova Medical School, Padova, Italy
,
Amelia Ruffatti
2   Division of Rheumatology, Department of Medical and Surgical Sciences, University of Padova Medical School, Padova, Italy
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Publikationsdatum:
07. März 2012 (online)

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Abstract

Venous or arterial thrombosis or pregnancy morbidity in the presence of circulating antiphospholipid antibodies (aPL) define the antiphospholipid syndrome (APS). In terms of accepted APS criteria, aPL are detected by one coagulation test (lupus anticoagulant; LAC) and two immunoassays (anticardiolipin antibodies and anti-β2-glycoptrotein I antibodies). In patients with APS, a single positive test carries a much lower risk of thrombosis recurrence or new pregnancy loss than does multiple (or triple) positivity. The same holds true for aPL carriers, namely subjects with laboratory tests but without clinical criteria for APS. Thus, very different risk categories exist among patients with APS as well as in carriers of aPL. Triple positivity apparently identifies the pathogenic autoantibody (antidomain I-II of β2-glycoptrotein I); it is in this category of patients that trials on new therapeutic strategies should focus.