Antiphospholipid syndrome: a clinical and laboratorial challenge

Detalhes bibliográficos
Autor(a) principal: Dusse,Luci Maria Santana
Data de Publicação: 2014
Outros Autores: Silva,Fernanda Dias e, Freitas,Letícia Gonçalves, Rios,Danyelle Romana Alves, Armond,Sandra Cristina, Marcolino,Milena Soriano
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista da Associação Médica Brasileira (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302014000200181
Resumo: Antiphospholipid syndrome (APS) is an acquired autoimmune thrombophilia characterized by the presence of a heterogeneous family of antibodies that bind to plasma proteins with affinity for phospholipid surfaces. The two major protein targets of antiphospholipid antibodies are prothrombin and β2-glycoprotein I (β2GPI). APS leads to aprothrombotic state, and it is characterized by the occurrence of arterial, venous or microvascular thrombosis or recurrent fetal loss. The diagnosis of APS is based on a set of clinical criteria and the detection of lupus anticoagulant (LA), anticardiolipin antibodies (ACA) or anti-β2GPI in plasma. Although laboratory tests are essential for APS diagnosis, these tests have limitations associated with the robustness, reproducibility and standardization. The standardization of diagnostic tests for detection of APLAs has been a challenge and a variety of results have been obtained using different commercial kits and in-house techniques. An increased sensitivity of the ELISA kits for detection of ACA effectively has contributed to APS diagnosis. However, the lack of specificity associated with a high number of false-positive results is a clinical and laboratorial challenge, since such results may lead to mistaken clinical decisions, such as prescription of oral anticoagulant, leading to the risk of hemorrhaging. Furthermore, clinicians are often unfamiliar with these tests and have difficulty interpreting them, requiring interaction between clinical and laboratory professionals in order to ensure their correct interpretation.
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spelling Antiphospholipid syndrome: a clinical and laboratorial challengeantiphospholipid syndromeclinical diagnosislaboratorial testspre-analytical phaseAntiphospholipid syndrome (APS) is an acquired autoimmune thrombophilia characterized by the presence of a heterogeneous family of antibodies that bind to plasma proteins with affinity for phospholipid surfaces. The two major protein targets of antiphospholipid antibodies are prothrombin and β2-glycoprotein I (β2GPI). APS leads to aprothrombotic state, and it is characterized by the occurrence of arterial, venous or microvascular thrombosis or recurrent fetal loss. The diagnosis of APS is based on a set of clinical criteria and the detection of lupus anticoagulant (LA), anticardiolipin antibodies (ACA) or anti-β2GPI in plasma. Although laboratory tests are essential for APS diagnosis, these tests have limitations associated with the robustness, reproducibility and standardization. The standardization of diagnostic tests for detection of APLAs has been a challenge and a variety of results have been obtained using different commercial kits and in-house techniques. An increased sensitivity of the ELISA kits for detection of ACA effectively has contributed to APS diagnosis. However, the lack of specificity associated with a high number of false-positive results is a clinical and laboratorial challenge, since such results may lead to mistaken clinical decisions, such as prescription of oral anticoagulant, leading to the risk of hemorrhaging. Furthermore, clinicians are often unfamiliar with these tests and have difficulty interpreting them, requiring interaction between clinical and laboratory professionals in order to ensure their correct interpretation.Associação Médica Brasileira2014-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302014000200181Revista da Associação Médica Brasileira v.60 n.2 2014reponame:Revista da Associação Médica Brasileira (Online)instname:Associação Médica Brasileira (AMB)instacron:AMB10.1590/1806-9282.60.02.016info:eu-repo/semantics/openAccessDusse,Luci Maria SantanaSilva,Fernanda Dias eFreitas,Letícia GonçalvesRios,Danyelle Romana AlvesArmond,Sandra CristinaMarcolino,Milena Sorianoeng2015-01-09T00:00:00Zoai:scielo:S0104-42302014000200181Revistahttps://ramb.amb.org.br/ultimas-edicoes/#https://old.scielo.br/oai/scielo-oai.php||ramb@amb.org.br1806-92820104-4230opendoar:2015-01-09T00:00Revista da Associação Médica Brasileira (Online) - Associação Médica Brasileira (AMB)false
dc.title.none.fl_str_mv Antiphospholipid syndrome: a clinical and laboratorial challenge
title Antiphospholipid syndrome: a clinical and laboratorial challenge
spellingShingle Antiphospholipid syndrome: a clinical and laboratorial challenge
Dusse,Luci Maria Santana
antiphospholipid syndrome
clinical diagnosis
laboratorial tests
pre-analytical phase
title_short Antiphospholipid syndrome: a clinical and laboratorial challenge
title_full Antiphospholipid syndrome: a clinical and laboratorial challenge
title_fullStr Antiphospholipid syndrome: a clinical and laboratorial challenge
title_full_unstemmed Antiphospholipid syndrome: a clinical and laboratorial challenge
title_sort Antiphospholipid syndrome: a clinical and laboratorial challenge
author Dusse,Luci Maria Santana
author_facet Dusse,Luci Maria Santana
Silva,Fernanda Dias e
Freitas,Letícia Gonçalves
Rios,Danyelle Romana Alves
Armond,Sandra Cristina
Marcolino,Milena Soriano
author_role author
author2 Silva,Fernanda Dias e
Freitas,Letícia Gonçalves
Rios,Danyelle Romana Alves
Armond,Sandra Cristina
Marcolino,Milena Soriano
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Dusse,Luci Maria Santana
Silva,Fernanda Dias e
Freitas,Letícia Gonçalves
Rios,Danyelle Romana Alves
Armond,Sandra Cristina
Marcolino,Milena Soriano
dc.subject.por.fl_str_mv antiphospholipid syndrome
clinical diagnosis
laboratorial tests
pre-analytical phase
topic antiphospholipid syndrome
clinical diagnosis
laboratorial tests
pre-analytical phase
description Antiphospholipid syndrome (APS) is an acquired autoimmune thrombophilia characterized by the presence of a heterogeneous family of antibodies that bind to plasma proteins with affinity for phospholipid surfaces. The two major protein targets of antiphospholipid antibodies are prothrombin and β2-glycoprotein I (β2GPI). APS leads to aprothrombotic state, and it is characterized by the occurrence of arterial, venous or microvascular thrombosis or recurrent fetal loss. The diagnosis of APS is based on a set of clinical criteria and the detection of lupus anticoagulant (LA), anticardiolipin antibodies (ACA) or anti-β2GPI in plasma. Although laboratory tests are essential for APS diagnosis, these tests have limitations associated with the robustness, reproducibility and standardization. The standardization of diagnostic tests for detection of APLAs has been a challenge and a variety of results have been obtained using different commercial kits and in-house techniques. An increased sensitivity of the ELISA kits for detection of ACA effectively has contributed to APS diagnosis. However, the lack of specificity associated with a high number of false-positive results is a clinical and laboratorial challenge, since such results may lead to mistaken clinical decisions, such as prescription of oral anticoagulant, leading to the risk of hemorrhaging. Furthermore, clinicians are often unfamiliar with these tests and have difficulty interpreting them, requiring interaction between clinical and laboratory professionals in order to ensure their correct interpretation.
publishDate 2014
dc.date.none.fl_str_mv 2014-01-01
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302014000200181
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dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv 10.1590/1806-9282.60.02.016
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.publisher.none.fl_str_mv Associação Médica Brasileira
publisher.none.fl_str_mv Associação Médica Brasileira
dc.source.none.fl_str_mv Revista da Associação Médica Brasileira v.60 n.2 2014
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