Influence of different IgG anticardiolipin antibody cut-off values on antiphospholipid syndrome classification
Influence of different IgG anticardiolipin antibody cut-off values on antiphospholipid syndrome classification
复制标题
DOI：
10.1111/j.1538-7836.2008.03121.x
复制
发表时间：
2008-10-01
影响因子：
10.4
通讯作者：
Pengo, V.
中科院分区：
文献类型：
--
作者：
Ruffatti, A.;Olivieri, S.;Pengo, V.
背景资料：虽然中至高滴度的抗心磷脂（aCL）抗体（定义为> 40 GPL单位或>第99百分位数）是抗磷脂综合征（APS）“明确”诊断的实验室标准，但两个临界值之间的一致性尚未得到验证。目的：通过验证两个临界值对APS分类的影响，验证现行ACL实验室标准。患者/方法：根据GPL值高于第99百分位数（17.4 GPL）选择90例aCL阳性APS患者，该值通过测试100例年龄和性别匹配的健康受试者计算。结果如下：IgG阳性的显著差异在APS实验室特征之间发现（P < 0.0001），24例中有20例（83.3%）患者为单一阳性（仅ACL），23个中的6个（26.1%）双阳性（aCL加狼疮抗凝剂或抗β（2）糖蛋白I），在43例三重阳性（aCL+狼疮抗凝剂和抗β 2糖蛋白I）中，没有一例滴度在第99百分位数和40 GPL单位之间。此外，与血管血栓形成患者（16.9%）和两种疾病患者（16.7%）相比，妊娠并发症患者（73.7%）的aCL值在第99百分位数和40 GPL单位之间的比率显著更高（P < 0.0001）。结论：对于APS分类，第99百分位数临界值似乎比> 40 GPL值更敏感，因为它包括单独aCL阳性的受试者以及妊娠发病率患者。
Background: While medium to high titers of anticardiolipin (aCL) antibodies, defined as > 40 GPL units or > 99th percentile, is a laboratory criteria for the 'definite' diagnosis of antiphospholipid syndrome (APS), agreement between the two cut-offs has not been validated. Objective: To validate the current aCL laboratory criterion by verifying the effect of the two cut-offs on APS classification. Patients/methods: Ninety aCL positive APS patients were selected on the basis of their GPL values above the 99th percentile (17.4 GPL), which was calculated by testing 100 age- and sex-matched healthy subjects. Results: A significant difference in the IgG positivity (P < 0.0001) was found between the APS laboratory profiles as 20 out of the 24 (83.3%) patients with single positivity (aCL alone), six out of the 23 (26.1%) with double positivity (aCL plus lupus anticoagulant or anti-beta(2)glycoprotein I), and none out of the 43 with triple positivity (aCL plus lupus anticoagulant and anti-beta(2)glycoprotein I) had titers between the 99th percentile and 40 GPL units. Moreover, the rate of aCL values between the 99th percentile and 40 GPL units was significantly higher (P < 0.0001) in patients with pregnancy morbidity (73.7%) as compared to those with vascular thrombosis (16.9%) and those with both conditions (16.7%). Conclusion: The 99th percentile cut-off level seems more sensitive than the > 40 GPL value for APS classification, as it includes subjects with aCL positivity alone as well as patients with pregnancy morbidity.