Anti Cardiolipin Antibody (IgG+IgM)

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Antibody test for antiphospholipid syndrome.

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Anti Cardiolipin Antibody (IgG+IgM) - Comprehensive Medical Test Guide

Why is it done?
- Test Purpose: Detects antibodies against cardiolipin, a phospholipid found on cell membranes. This test identifies antiphospholipid antibodies associated with abnormal blood clotting and autoimmune disorders.
- Primary Indications: Unexplained thrombosis (blood clots in veins or arteries), recurrent miscarriages, suspected antiphospholipid syndrome (APS), evaluation of autoimmune disease, and assessment of bleeding or clotting disorders.
- Clinical Circumstances: After first occurrence of deep vein thrombosis (DVT) or pulmonary embolism (PE) in young patients, after arterial thrombosis, multiple miscarriages or fetal loss, positive lupus anticoagulant screening, or when systemic lupus erythematosus (SLE) or other connective tissue diseases are suspected.
Normal Range
- Reference Values: Less than 10 GPL-U/mL for IgG (GPL = Glycoprotein units). Less than 10 MPL-U/mL for IgM (MPL = MPL units). Borderline range: 10-15 GPL-U/mL for IgG and 10-15 MPL-U/mL for IgM.
- Interpretation Categories: Negative (Normal) = <10 U/mL, Borderline = 10-15 U/mL, Low Positive = 15-40 U/mL, Medium Positive = 40-80 U/mL, High Positive = >80 U/mL.
- What Normal Means: Normal results suggest absence of antiphospholipid antibodies and indicate lower risk of antiphospholipid syndrome or thrombotic complications. However, does not completely exclude APS as other antiphospholipid antibodies (such as beta-2 glycoprotein I or phosphatidylserine antibodies) may still be present.
- What Abnormal Means: Positive or elevated results suggest presence of antiphospholipid antibodies and increased thrombotic risk. Higher titers (>40 U/mL) are associated with greater clinical significance and increased likelihood of thrombotic events or pregnancy complications.
Interpretation
- Negative Results (<10 U/mL): Indicates absence of detectable cardiolipin antibodies. Patient has lower risk of thrombotic complications related to antiphospholipid antibodies, though other causes of thrombosis or pregnancy loss should still be investigated.
- Borderline Results (10-15 U/mL): Requires repeat testing in 8-12 weeks to confirm persistence of antibodies. Borderline results may represent transient antibodies or early seroconversion. Clinical correlation with symptoms and other test results is essential.
- Positive Results (>15 U/mL): Suggests presence of antiphospholipid antibodies with clinical significance. Repeat testing and assessment of other antiphospholipid antibodies (beta-2 glycoprotein I, phosphatidylserine) recommended. Clinical features combined with persistently positive results support diagnosis of antiphospholipid syndrome.
- IgG vs IgM Distinction: IgG antibodies are more specific for APS and associated with thrombotic complications. IgM antibodies alone may indicate transient infection or early immune response. Combined IgG and IgM positivity suggests active or persistent immune response.
- Titer Significance: Higher titers (>40 U/mL) correlate with increased thrombotic risk and are more likely to be associated with clinical manifestations. Medium to high positive results warrant more aggressive monitoring and potential anticoagulation therapy.
- Factors Affecting Results: Infections (viral, bacterial), malignancy, certain medications, recent vaccinations, hemolysis during sample collection, and technical factors can influence results. Transient antibodies may disappear within weeks to months, while persistent antibodies suggest true antiphospholipid antibody syndrome.
Associated Organs
- Primary Organ Systems: Cardiovascular system (blood vessels, heart), hematologic system (blood and coagulation), reproductive system (placenta, fetus), and nervous system (cerebral vasculature).
- Associated Diseases and Conditions: Antiphospholipid syndrome (primary or secondary), systemic lupus erythematosus (SLE), other connective tissue diseases (rheumatoid arthritis, Sjögren's syndrome), antiphospholipid antibody-associated nephropathy, thrombotic events.
- Complications and Risks: Deep vein thrombosis, pulmonary embolism, arterial thrombosis (stroke, myocardial infarction), recurrent miscarriage, intrauterine fetal death, preeclampsia, thrombotic microangiopathy, catastrophic antiphospholipid syndrome (multiple organ thrombosis), and renal dysfunction.
- Pregnancy-Related Complications: Recurrent first-trimester miscarriages, fetal loss after 10 weeks gestation, severe preeclampsia, placental insufficiency, intrauterine growth restriction, and intrauterine fetal death. Positive cardiolipin antibodies warrant specialized obstetric management.
Follow-up Tests
- Confirmatory Tests: Repeat anti-cardiolipin antibody testing in 8-12 weeks for borderline or weakly positive results to confirm persistence. Beta-2 glycoprotein I (anti-β2GPI) antibodies for comprehensive antiphospholipid antibody profile. Lupus anticoagulant testing (critical for APS diagnosis).
- Additional Autoimmune Markers: Antinuclear antibody (ANA), anti-double stranded DNA (anti-dsDNA), anti-Smith (anti-Sm) antibodies, rheumatoid factor, complement levels (C3, C4) to evaluate for systemic lupus erythematosus.
- Coagulation Studies: Prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen level, platelet count to assess overall coagulation status and screen for thrombocytopenia.
- Imaging Studies: Doppler ultrasound of lower extremities for suspected DVT, computed tomography pulmonary angiography (CTPA) for suspected PE, brain MRI for unexplained neurological symptoms or stroke.
- Monitoring Frequency: Initial diagnosis: Repeat testing at 8-12 weeks. Established APS: Annual monitoring or as clinically indicated. During pregnancy: Every trimester with positive antibodies. After thrombotic event: Testing to establish baseline and guide anticoagulation decisions.
- Other Complementary Tests: Phosphatidylserine antibodies, phosphatidylinositol antibodies, prothrombin antibodies, tissue factor pathway inhibitor antibodies. D-dimer (elevated in thrombotic disease), fibrin degradation products.
Fasting Required?
- Fasting Status: NO - Fasting is not required for anti-cardiolipin antibody testing. This is an immunological test not affected by food intake or glucose levels.
- Patient Preparation: Patient may eat and drink normally before the test. No special preparation required. Patient should be well-hydrated to facilitate blood draw.
- Specimen Collection: Blood sample collected via venipuncture into a serum separator tube (SST) or plasma tube depending on laboratory protocol. Approximately 5-7 mL of blood drawn. Sample should not be hemolyzed or significantly lipemic as this affects antibody detection.
- Medication Considerations: Continue all regular medications unless otherwise instructed by healthcare provider. Anticoagulant therapy (warfarin, heparin) does not affect test results. Inform healthcare provider of all current medications as some may influence immune response interpretation.
- Timing Considerations: Test can be performed at any time of day. Avoid testing during acute infection or immediately after vaccination (within 2 weeks) as this may cause false-positive results. Allow at least 8-12 weeks before repeat testing for confirmatory results.

How our test process works!