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Arthritis Research & Therapy
Published in: Arthritis Research & Therapy 1/2020

Open Access 01-12-2020 | Systemic Lupus Erythematosus | Research article

“Non-criteria” antiphospholipid antibodies add value to antiphospholipid syndrome diagnoses in a large Chinese cohort

Authors: Tingting Liu, Jieyu Gu, Liyan Wan, Qiongyi Hu, Jialin Teng, Honglei Liu, Xiaobing Cheng, Junna Ye, Yutong Su, Yue Sun, Jinfeng Zhou, Gary L. Norman, Xuefeng Wang, Chengde Yang, Hui Shi

Published in: Arthritis Research & Therapy | Issue 1/2020

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Abstract

Background

Despite expansion in the 2006 Sydney antiphospholipid syndrome (APS) classification criteria to include IgG/IgM anti-β2-glycoprotein (aβ2GPI) antibodies in addition to IgG/IgM anti-cardiolipin antibodies (aCL) and lupus anticoagulant (LAC), some individuals with clinical features of APS remain seronegative (seronegative APS or SNAPS) and are at risk of recurrent thrombosis and pregnancy morbidities. Our aim was to assess the value of “non-criteria” aPL antibodies to detect these SNAPS patients.

Methods

One hundred ninety-two APS patients, 90 SNAPS patients, 193 autoimmune disease controls, and 120 healthy controls were evaluated. Ten antiphospholipid antibodies (aPLs) were tested using commercial kits, including 5 non-criteria aPLs: anti-phosphatidylserine/prothrombin antibodies (aPS/PT) IgG/IgM, aCL IgA, aβ2GPI IgA, and anti-β2GPI Domain 1 (aβ2GPI-D1) IgG.

Results

Up to 60.9% of the SNAPS and 93.5% of APS patients were detected by at least one non-criteria aPL. aPS/PT IgG had the highest Youden index in classifying APS and SNAPS from controls. aPS/PT IgG and aβ2GPI Domain 1 IgG seem to be the most significant risk factors for thrombotic events and pregnancy morbidity, respectively. aPS/PT IgG/IgM and aβ2GPI-D1 IgG were detected in some SNAPS patients, while IgA isotypes of aCL/aβ2GPI tended to appear together with other biomarkers. The combined analysis showed enhanced diagnostic performance with the inclusion of non-criteria aPLs.

Conclusions

Recognition of SNAPS patients is critical for clinical management and prevention of potential thrombotic and obstetric adverse events. The non-criteria antiphospholipid antibodies help to identify a considerable portion (60.9%) of these patients who otherwise may remain untreated and at clinical risk.
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Metadata
Title
“Non-criteria” antiphospholipid antibodies add value to antiphospholipid syndrome diagnoses in a large Chinese cohort
Authors
Tingting Liu
Jieyu Gu
Liyan Wan
Qiongyi Hu
Jialin Teng
Honglei Liu
Xiaobing Cheng
Junna Ye
Yutong Su
Yue Sun
Jinfeng Zhou
Gary L. Norman
Xuefeng Wang
Chengde Yang
Hui Shi
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 1/2020
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/s13075-020-2131-4

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