Antiphospholipid syndrome diagnostic criteria: Difference between revisions
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==Overview== | ==Overview== | ||
The diagnosis of | The diagnosis of Antiphospholipid syndrome is made in case of a clinical event (vascular [[thrombosis]] or [[pregnancy]] event) '''and''' repeated positive tests of aPL performed 12 weeks apart (repeat aPL testing is necessary due to the naturally occurring presence of transient low levels of aPL following infections). | ||
==Diagnostic Criteria== | ==Diagnostic Criteria== | ||
The Updated Sapporo APS Classification Criteria are commonly used for APS diagnosis.<ref>Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4:295-306)</ref> Based on these criteria, APS diagnosis requires: | The Updated Sapporo APS Classification Criteria are commonly used for APS diagnosis.<ref>Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4:295-306)</ref> Based on these criteria, APS diagnosis requires: | ||
* a) ''Vascular Thrombosis'' (blood clots) in any organ or tissue '''or''' ''Pregnancy Event'' (one or more | * a) ''Vascular Thrombosis'' (blood clots) in any organ or tissue '''or''' ''Pregnancy Event'' (one or more [[miscarriage]]s after 10th week of [[gestation]], three or more miscarriages before 10th week of gestation, or one or more premature births before 34th week of gestation due to [[eclampsia]]) '''and''' | ||
* b) ''Persistenly (12 weeks apart) Positive aPL'' (lupus anticoagulant test, moderate-to-high titer anticardiolipin antibodies, or moderate-to-high titer β<sub>2</sub>-glycoprotein-I antibodies). | * b) ''Persistenly (12 weeks apart) Positive aPL'' ([[lupus anticoagulant test]], moderate-to-high titer [[anticardiolipin antibodies]], or moderate-to-high titer β<sub>2</sub>-glycoprotein-I antibodies). | ||
The International Consensus Statement is commonly used for Catastrophic APS diagnosis.<ref>{{cite journal |author=Asherson RA, Cervera R, de Groot PG, ''et al'' |title=Catastrophic antiphospholipid syndrome: international consensus statement on classification criteria and treatment guidelines |journal=Lupus |volume=12 |issue=7 |pages=530-4 |year=2003 |pmid=12892393 |doi=}}</ref> Based on this statement, Definite CAPS diagnosis requires: | The International Consensus Statement is commonly used for Catastrophic APS diagnosis.<ref>{{cite journal |author=Asherson RA, Cervera R, de Groot PG, ''et al'' |title=Catastrophic antiphospholipid syndrome: international consensus statement on classification criteria and treatment guidelines |journal=Lupus |volume=12 |issue=7 |pages=530-4 |year=2003 |pmid=12892393 |doi=}}</ref> Based on this statement, Definite CAPS diagnosis requires: | ||
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Revision as of 12:54, 29 October 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The diagnosis of Antiphospholipid syndrome is made in case of a clinical event (vascular thrombosis or pregnancy event) and repeated positive tests of aPL performed 12 weeks apart (repeat aPL testing is necessary due to the naturally occurring presence of transient low levels of aPL following infections).
Diagnostic Criteria
The Updated Sapporo APS Classification Criteria are commonly used for APS diagnosis.[1] Based on these criteria, APS diagnosis requires:
- a) Vascular Thrombosis (blood clots) in any organ or tissue or Pregnancy Event (one or more miscarriages after 10th week of gestation, three or more miscarriages before 10th week of gestation, or one or more premature births before 34th week of gestation due to eclampsia) and
- b) Persistenly (12 weeks apart) Positive aPL (lupus anticoagulant test, moderate-to-high titer anticardiolipin antibodies, or moderate-to-high titer β2-glycoprotein-I antibodies).
The International Consensus Statement is commonly used for Catastrophic APS diagnosis.[2] Based on this statement, Definite CAPS diagnosis requires:
- a) Vascular Thrombosis in three or more organs or tissues and
- b) Development of manifestations simultaneously or in less than a week 'and
- c) Evidence of small vessel thrombosis in at least one organ or tissue and
- d) Laboratory confirmation of the presence of aPL.
Some serological tests for syphilis may be positive in aPL-positive patients (aPL bind to the lipids in the test and make it come out positive) although the more specific tests for syphilis that use recombinant antigens will be negative.
References
- ↑ Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4:295-306)
- ↑ Asherson RA, Cervera R, de Groot PG; et al. (2003). "Catastrophic antiphospholipid syndrome: international consensus statement on classification criteria and treatment guidelines". Lupus. 12 (7): 530–4. PMID 12892393.