Phospholipid antibodies can be detected by two assay methods:
- Cardiolipin antibody* (CLAK; anti-cardiolipin antibody (aCL) of IgG and/or IgM isotype) – can be determined directly by ELISA.
- Lupus anticoagulant (LA) – modified coagulation test.
* The cardiolipin antibody is commonly found in individuals suffering from collagenoses.
The procedure
Material needed
Preparation of the patient
- Not necessary
Disruptive factors
- None known
Normal value – cardiolipin IgG antibody
| Normal value in E (IgG) | < 19 |
| Normal value in E (IgM) | < 10 |
Normal value – lupus anticoagulant
| Normal value | Negative |
Indications
- Suspicion of increased thrombotic tendency (thrombophilia screening).
- V. a. phospholipid antibody syndrome
- PTT prolongation (for differential diagnosis).
- Clarification of the cause of habitual abortions (at least 3 repeated abortions/miscarriages).
Interpretation
Interpretation of increased values
- Primary antiphospholipid syndrome (APS; antiphospholipid antibody syndrome) – autoimmune disease; predominantly women develop the disease (gynecotropia); characterized by the following triad:
- Venous and/or arterial thrombosis (blood clot (thrombus) in a blood vessel).
- Thrombocytopenia (lack of platelets (thrombocytes) in the blood).
- Recurrent spontaneous abortions (occurrence of three or more consecutive spontaneous abortions before 20 weeks’ gestation/pregnancy).
- Secondary anti-phospholipd syndrome triggered by circulating phospholipid antibodies (aPL) – syndrome involving recurrent thrombosis and abortion due to systemic lupus erythematosus (SLE) or other collagenoses.
Phospholipid antibodies (aPL) can be detected in, among others:
- Approximately 20% of patients who suffer an apoplexy (stroke) at the age of less than 50 years.
- Approximately 10-15% of women with repeated miscarriages (miscarriages).
- Approximately 11-29% of women with preeclampsia (occurrence of hypertension (high blood pressure) during pregnancy).
Elevated cardiolipin antibodies are present in:
- SLE (40% of patients) or other collagenoses.
- Drug-induced lupoid diseases.
- Rheumatoid arthritis (synonym: chronic polyarthritis) – most common inflammatory disease of the joints.
- Bacterial infections (e.g., lues)
- Viral infections (e.g. HIV, EBV)
- Lymphoproliferative diseases
Interpretation of decreased values
- Elevated factor VIII levels (falsely low).
- Genetically determined protein C deficiency – homozygous/heterozygous protein C deficiency.
- Liver disease, unspecified
- Vitamin K deficiency
