Kempers Eva K, Dalm Virgil A S H, van Rijn Marie Josee E, Mulders Annemarie G M G J, Leebeek Frank W G, de Maat Moniek P M, Jansen A J Gerard
Department of Hematology.
Department of Immunology.
Rheumatol Adv Pract. 2021 Nov 27;5(3):rkab093. doi: 10.1093/rap/rkab093. eCollection 2021.
Lupus anticoagulans (LACs) and aPLs, both further summarized as aPL, are frequently assessed in routine daily clinical practice in diagnostic workups for suspected autoimmune diseases or to test for underlying risk factors in patients with thrombosis or obstetric complications. The aim of this study was to determine the prevalence of aPL positivity in patients with an indication for aPL testing in routine clinical practice.
In this retrospective single-centre study, indication for aPL testing, aPL test results and clinical data were collected for patients tested between June 2015 and April 2018.
During the study period, 16 847 single aPL tests were performed in 2139 patients. In 212 patients one or more positive aPL test was found, confirmed in 43.9% with a second positive test. Indications for aPL testing were diagnostic workup/follow-up of autoimmune diseases (33.6%), thrombosis (21.4%) and obstetric complications (28%). Seventy-four patients (3.5% of all patients) fulfilled the criteria of APS, of whom 51% were newly diagnosed. Second positive aPL titres and titres of APS patients were significantly higher compared with positive aPL titres at the first measurement ( < 0.05). Patients with indications of arterial thrombosis and diagnostic workup/follow-up of autoimmune diseases had significantly higher levels of aCL IgG and anti-β2 glycoprotein I (β2GPI) IgG compared with patients with other indications.
The prevalence of one or more positive aPL test was 9.9% and APS was diagnosed in 3.5% of the patients. Patients with arterial thrombosis had significantly higher anti-β2GPI IgG and aCL IgG, which should be confirmed in future studies.
狼疮抗凝物（LACs）和抗磷脂抗体（aPLs），两者统称为aPL，在日常临床实践中常用于疑似自身免疫性疾病的诊断检查，或用于检测血栓形成或产科并发症患者的潜在危险因素。本研究的目的是确定在常规临床实践中有aPL检测指征的患者中aPL阳性的患病率。
在这项回顾性单中心研究中，收集了2015年6月至2018年4月期间接受检测患者的aPL检测指征、aPL检测结果和临床数据。
在研究期间，对2139例患者进行了16847次单次aPL检测。在212例患者中发现一项或多项aPL检测呈阳性，其中43.9%通过第二次阳性检测得到确认。aPL检测的指征包括自身免疫性疾病的诊断检查/随访（33.6%）、血栓形成（21.4%）和产科并发症（28%）。74例患者（占所有患者的3.5%）符合抗磷脂综合征（APS）标准，其中51%为新诊断患者。与首次测量时的阳性aPL滴度相比，第二次阳性aPL滴度和APS患者的滴度显著更高（P<0.05）。与其他指征的患者相比，有动脉血栓形成指征以及自身免疫性疾病诊断检查/随访的患者，其抗心磷脂抗体（aCL）IgG和抗β2糖蛋白I（β2GPI）IgG水平显著更高。
一项或多项aPL检测呈阳性的患病率为9.9%，3.5%的患者被诊断为APS。动脉血栓形成患者的抗β2GPI IgG和aCL IgG显著更高，这一点应在未来研究中得到证实。
