Diagnostic Trends in Laboratory Evaluation of Antiphospholipid Syndrome
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by vascular thrombosis and/or pregnancy-related morbidity accompanied by persistently positive antiphospholipid (aPL) antibodies. Current recommended laboratory tests include immunoassays for detecting IgG and IgM antibodies to cardiolipin (aCL), and beta-2 glycoprotein I (anti-β2GPI) as well as coagulation-based assays for lupus anticoagulant activities. It is increasingly recognized that a subset of patients with classical features of APS do test negative for the recommended criteria aPL tests. While APS experts acknowledge that such patients may have clinical features that are not of an autoimmune etiology, ‘seronegativity’ for criteria autoantibodies may also be due in part to the absence of harmonization and/or standardization of current aPL antibody assays. Alternatively, patients ‘seronegative’ for the recommended tests may have aPL antibodies that target other antigens involved in the pathogenesis of APS with possible relevance for risk assessment and treatment. This presentation will focus on current and emerging aPL antibodies and the evolving concepts for their use in the evaluation and management of APS.
Originally presented on July 25, 2016 in Salt Lake City, Utah.
Anne E. Tebo, PhD
Medical Director, Immunology, ARUP Laboratories
Associate Professor of Pathology, University of Utah School of Medicine
Dr. Tebo is an associate professor of pathology at the University of Utah School of Medicine. She received her PhD from the Eberhard Karls Universität Tübingen in Germany and completed postdoctoral training in immunology from the Department of Microbiology at the University of Birmingham at Alabama. Dr. Tebo continued her training with a clinical immunology fellowship at the Department of Pathology in the University of Utah School of Medicine. She currently directs the Autoimmune Immunology Laboratory at ARUP Laboratories and is board certified in medical laboratory immunology by the American Board of Medical Laboratory Immunology (ABMLI). Dr. Tebo is a member of the Association of the Medical Laboratory Immunologists (AMLI), the American Association of Clinical Chemists (AACC), and the American College of Rheumatology (ACR).
After this presentation, participants will be able to:
- Define the laboratory classification criteria for Antiphospholipid Syndrome (APS).
- Identify at least two antiphospholipid antibody tests that are not part of the classification criteria.
- Describe the significance of antiphospholipid antibody profile in risk stratification of APS.
University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories