Antiphospholipid antibodies: what is new in 2022 2022

Sophie Melicine, and Nicolas Gendron, and Luc Darnige, and Laetitia Mauge
Service d’hématologie biologique, Hôpital Necker, APHP, Paris, France

Antiphospholipid syndrome (APS) is a clinicobiological entity defined by the association of thrombotic events and/or obstetric complications and the presence of persistent antiphospholipid antibodies (aPLs) detected by coagulation tests (lupus anticoagulant, LAC) and/or immunological assays (anticardiolipin and anti-glycoprotein-beta-I antibodies). The increased use of direct oral anticoagulants (DOAC) for the treatment of venous thromboembolism (VTE) is now a challenge for hematology laboratories for the diagnosis of APS. DOAC interfere with LAC screening and confirmation tests resulting in a risk of false positive results. To avoid these interferences, several solutions are suggested. Some of them rely on the use of DOAC-reversal systems (activated charcoal tablet, filter system) others on the use of reagents insensitive to DOAC presence in the sample. Detection of anti-phosphatidylserine/prothrombin antibodies may be helpful because they are strongly associated to the presence of LAC and are increasingly recognized as a useful tool in the diagnosis and prognosis of APS. Finally, positivity of LA in the setting of a viral infection is frequent and not specific to APS. During the Covid-19 pandemic, many patients developed arterial and VTE that could suggest testing for aPLs. The association between LAC and a risk of VTE or in-hospital mortality in hospitalized Covid-19 patients was not demonstrated. Moreover, aPLs do not persist after Covid-19. Currently, testing for aPLs in Covid-19 patients is not recommended.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000086382 COVID-19 A viral disorder generally characterized by high FEVER; COUGH; DYSPNEA; CHILLS; PERSISTENT TREMOR; MUSCLE PAIN; HEADACHE; SORE THROAT; a new loss of taste and/or smell (see AGEUSIA and ANOSMIA) and other symptoms of a VIRAL PNEUMONIA. In severe cases, a myriad of coagulopathy associated symptoms often correlating with COVID-19 severity is seen (e.g., BLOOD COAGULATION; THROMBOSIS; ACUTE RESPIRATORY DISTRESS SYNDROME; SEIZURES; HEART ATTACK; STROKE; multiple CEREBRAL INFARCTIONS; KIDNEY FAILURE; catastrophic ANTIPHOSPHOLIPID ANTIBODY SYNDROME and/or DISSEMINATED INTRAVASCULAR COAGULATION). In younger patients, rare inflammatory syndromes are sometimes associated with COVID-19 (e.g., atypical KAWASAKI SYNDROME; TOXIC SHOCK SYNDROME; pediatric multisystem inflammatory disease; and CYTOKINE STORM SYNDROME). A coronavirus, SARS-CoV-2, in the genus BETACORONAVIRUS is the causative agent. 2019 Novel Coronavirus Disease,2019 Novel Coronavirus Infection,2019-nCoV Disease,2019-nCoV Infection,COVID-19 Pandemic,COVID-19 Pandemics,COVID-19 Virus Disease,COVID-19 Virus Infection,Coronavirus Disease 2019,Coronavirus Disease-19,SARS Coronavirus 2 Infection,SARS-CoV-2 Infection,Severe Acute Respiratory Syndrome Coronavirus 2 Infection,COVID19,2019 nCoV Disease,2019 nCoV Infection,2019-nCoV Diseases,2019-nCoV Infections,COVID 19,COVID 19 Pandemic,COVID 19 Virus Disease,COVID 19 Virus Infection,COVID-19 Virus Diseases,COVID-19 Virus Infections,Coronavirus Disease 19,Disease 2019, Coronavirus,Disease, 2019-nCoV,Disease, COVID-19 Virus,Infection, 2019-nCoV,Infection, COVID-19 Virus,Infection, SARS-CoV-2,Pandemic, COVID-19,SARS CoV 2 Infection,SARS-CoV-2 Infections,Virus Disease, COVID-19,Virus Infection, COVID-19
D000925 Anticoagulants Agents that prevent BLOOD CLOTTING. Anticoagulant Agent,Anticoagulant Drug,Anticoagulant,Anticoagulant Agents,Anticoagulant Drugs,Anticoagulation Agents,Indirect Thrombin Inhibitors,Agent, Anticoagulant,Agents, Anticoagulant,Agents, Anticoagulation,Drug, Anticoagulant,Drugs, Anticoagulant,Inhibitors, Indirect Thrombin,Thrombin Inhibitors, Indirect
D016682 Lupus Coagulation Inhibitor An antiphospholipid antibody found in association with a variety of diseases (e.g., SYSTEMIC LUPUS ERYTHEMATOSUS and ANTIPHOSPHOLIPID SYNDROME) as well as in healthy individuals. In vitro, the antibody interferes with the conversion of prothrombin to thrombin and prolongs the partial thromboplastin time. In vivo, it exerts a procoagulant effect resulting in thrombosis mainly in the larger veins and arteries. It further causes obstetrical complications, including fetal death and spontaneous abortion, as well as a variety of hematologic and neurologic complications. Lupus Anticoagulant,Lupus Anticoagulant Autoantibodies,Lupus Anticoagulant Autoantibody,Anticoagulant, Lupus,Coagulation Inhibitor, Lupus,Inhibitor, Lupus Coagulation,Anticoagulant Autoantibody, Lupus,Autoantibody, Lupus Anticoagulant
D016736 Antiphospholipid Syndrome The presence of antibodies directed against phospholipids (ANTIBODIES, ANTIPHOSPHOLIPID). The condition is associated with a variety of diseases, notably systemic lupus erythematosus and other connective tissue diseases, thrombopenia, and arterial or venous thromboses. In pregnancy it can cause abortion. Of the phospholipids, the cardiolipins show markedly elevated levels of anticardiolipin antibodies (ANTIBODIES, ANTICARDIOLIPIN). Present also are high levels of lupus anticoagulant (LUPUS COAGULATION INHIBITOR). Anti-Phospholipid Antibody Syndrome,Anti-Phospholipid Syndrome,Antiphospholipid Antibody Syndrome,Hughes Syndrome,Anti Phospholipid Antibody Syndrome,Anti Phospholipid Syndrome,Antibody Syndrome, Anti-Phospholipid,Antibody Syndrome, Antiphospholipid,Antiphospholipid Antibody Syndromes,Syndrome, Anti-Phospholipid,Syndrome, Anti-Phospholipid Antibody,Syndrome, Antiphospholipid,Syndrome, Antiphospholipid Antibody,Syndrome, Hughes
D017152 Antibodies, Antiphospholipid Autoantibodies directed against phospholipids. These antibodies are characteristically found in patients with certain autoimmune diseases (e.g., SYSTEMIC LUPUS ERYTHEMATOSUS and ANTIPHOSPHOLIPID SYNDROME), some non-autoimmune diseases, and also in healthy individuals. Antiphospholipid Antibodies,Antiphospholipid Autoantibodies,Antiphospholipid Autoantibody,Phospholipid Autoantibodies,Phospholipid Autoantibody,Antiphospholipid Antibody,Antibody, Antiphospholipid,Autoantibody, Antiphospholipid,Autoantibody, Phospholipid
D054556 Venous Thromboembolism Obstruction of a vein or VEINS (embolism) by a blood clot (THROMBUS) in the blood stream. Thromboembolism, Venous
D058873 Pandemics Epidemics of infectious disease that have spread to many countries, often more than one continent, and usually affecting a large number of people. Pandemic

Related Publications

Sophie Melicine, and Nicolas Gendron, and Luc Darnige, and Laetitia Mauge
December 1990, Lancet (London, England),
Sophie Melicine, and Nicolas Gendron, and Luc Darnige, and Laetitia Mauge
January 1995, Haematologica,
Sophie Melicine, and Nicolas Gendron, and Luc Darnige, and Laetitia Mauge
January 1994, Clinical and experimental rheumatology,
Sophie Melicine, and Nicolas Gendron, and Luc Darnige, and Laetitia Mauge
April 2007, Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases,
Sophie Melicine, and Nicolas Gendron, and Luc Darnige, and Laetitia Mauge
August 1994, AWHONN voice,
Sophie Melicine, and Nicolas Gendron, and Luc Darnige, and Laetitia Mauge
May 2012, Annales de dermatologie et de venereologie,
Sophie Melicine, and Nicolas Gendron, and Luc Darnige, and Laetitia Mauge
May 2024, Annales de pathologie,
Sophie Melicine, and Nicolas Gendron, and Luc Darnige, and Laetitia Mauge
December 2004, Current rheumatology reports,
Sophie Melicine, and Nicolas Gendron, and Luc Darnige, and Laetitia Mauge
September 2022, Paediatric respiratory reviews,
Sophie Melicine, and Nicolas Gendron, and Luc Darnige, and Laetitia Mauge
January 1997, La Revue de medecine interne,
Copied contents to your clipboard!