Antiphospholipid syndrome: a clinical and laboratorial challenge
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , |
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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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 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302014000200181 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302014000200181 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1806-9282.60.02.016 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
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 reponame:Revista da Associação Médica Brasileira (Online) instname:Associação Médica Brasileira (AMB) instacron:AMB |
instname_str |
Associação Médica Brasileira (AMB) |
instacron_str |
AMB |
institution |
AMB |
reponame_str |
Revista da Associação Médica Brasileira (Online) |
collection |
Revista da Associação Médica Brasileira (Online) |
repository.name.fl_str_mv |
Revista da Associação Médica Brasileira (Online) - Associação Médica Brasileira (AMB) |
repository.mail.fl_str_mv |
||ramb@amb.org.br |
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1754212831117443072 |