Antiphospolipid Syndrome Panel

Reproductive

Report in 36Hrs

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No Fasting Required

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Panel of antibodies (anticardiolipin, β2-glycoprotein, lupus anticoagulant).

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Antiphospholipid Syndrome Panel - Comprehensive Medical Test Guide

Why is it done?
- Detects antibodies against phospholipids, which are fatty molecules in cell membranes that can increase blood clotting risk and cause thrombosis (blood clots) and pregnancy complications
- Investigates unexplained blood clots (deep vein thrombosis, pulmonary embolism, arterial thrombosis) in young patients without typical risk factors
- Evaluates recurrent pregnancy loss, fetal demise, or severe preeclampsia in otherwise healthy women
- Assists in diagnosing Antiphospholipid Syndrome (APS), an autoimmune disorder characterized by thrombotic and obstetric complications
- Monitors patients with systemic lupus erythematosus (SLE) or other autoimmune conditions at risk for APS
- Typically performed when patients present with unexplained thrombosis, recurrent miscarriages, or have a family history of APS or thrombotic disease
Normal Range
- Lupus Anticoagulant (LAC): Negative (normal/not detected)
- Anticardiolipin Antibodies (aCL): Less than 12 GPL units/mL (IgG) or less than 12 MPL units/mL (IgM) - Negative
- Anti-Beta-2 Glycoprotein I Antibodies (aB2GPI): Less than 1.0 Unit/mL - Negative
- Interpretation of Results: Negative: No antiphospholipid antibodies detected; low risk for APS-related thrombosis Borderline/Weak Positive: 12-40 units - May warrant repeat testing or clinical correlation Moderate Positive: 40-80 units - Significant clinical risk High Positive: Greater than 80 units - Associated with higher thrombotic and obstetric risk
- Units: GPL/MPL units (Phospholipid units) or Seconds (for LAC); results are typically reported as Negative, Borderline, or Positive
Interpretation
- Negative Results: Patient is unlikely to have APS; thrombotic or obstetric complications likely due to other causes requiring alternative investigation
- Positive Lupus Anticoagulant: Strongest predictor of thrombotic risk; indicates prolonged phospholipid-dependent clotting tests (PT/INR, aPTT); associated with increased risk of clotting despite anticoagulation
- Positive Anticardiolipin Antibodies (IgG or IgM): Associated with thrombotic risk and pregnancy complications; IgG typically more significant clinically than IgM; high titers more likely to cause complications
- Positive Anti-Beta-2 Glycoprotein I Antibodies: Indicates true antiphospholipid antibody; most specific marker for APS; often correlates with thrombotic events; presence of multiple antibodies increases APS diagnosis likelihood
- Multiple Positive Antibodies: Triple-positive (LAC, aCL, and aB2GPI) significantly increases risk of thrombosis and recurrent pregnancy loss; warrants aggressive anticoagulation management
- Factors Affecting Results: - Timing of testing (antibodies may be transiently positive with infections) - Current anticoagulation therapy (may affect LAC results) - Active infection or malignancy - Certain medications (beta-blockers, hydralazine, procainamide) - Hemolysis or lipemia in blood sample - Presence of other autoimmune conditions (SLE, rheumatoid arthritis)
- Clinical Significance: APS diagnosis requires positive antibodies PLUS clinical features (thrombosis or pregnancy morbidity); persistent positivity on repeat testing 12+ weeks later is required for diagnosis confirmation
Associated Organs
- Primary Organ Systems: Vascular system (arteries and veins), blood coagulation system, placenta and reproductive system
- Medical Conditions Associated with Abnormal Results: - Antiphospholipid Syndrome (APS) - primary manifestation - Systemic Lupus Erythematosus (SLE) - 30-40% of SLE patients have antiphospholipid antibodies - Deep Vein Thrombosis (DVT) - Pulmonary Embolism (PE) - Arterial thrombosis (stroke, myocardial infarction, mesenteric infarction) - Recurrent pregnancy loss and miscarriage - Preeclampsia and eclampsia - Intrauterine fetal demise - Other autoimmune diseases (rheumatoid arthritis, Sjögren's syndrome)
- Potential Complications: - Life-threatening thrombosis in cerebral, coronary, or pulmonary vessels - Catastrophic APS (CAPS) - multiple simultaneous vessel occlusions with high mortality (50%) - Repeated fetal loss leading to infertility - Severe preeclampsia requiring premature delivery - Thrombotic complications during or after anticoagulation therapy - Organ infarction (renal, splenic, hepatic) - Skin necrosis and ulceration from dermal vessel thrombosis
- Mechanism of Pathology: Antiphospholipid antibodies bind to phospholipid-binding proteins (particularly beta-2 glycoprotein I), triggering platelet activation, tissue factor upregulation, and endothelial dysfunction, ultimately promoting thrombosis
Follow-up Tests
- Confirmatory Testing: Repeat antiphospholipid panel 12+ weeks after initial positive result to confirm persistent positivity (required for APS diagnosis)
- Coagulation Studies: Activated Partial Thromboplastin Time (aPTT), Prothrombin Time (PT/INR), Thrombin Time (TT), and Mixing Study to evaluate baseline coagulation status and monitor anticoagulation effect
- Complete Blood Count (CBC): To assess platelet count (thrombocytopenia can occur in APS) and screen for other hematologic abnormalities
- Comprehensive Metabolic Panel (CMP): To evaluate renal and hepatic function, especially if thrombotic complications or anticoagulation therapy is anticipated
- Autoimmune Panel: ANA, anti-dsDNA, complement levels (C3, C4) to evaluate for underlying SLE or other autoimmune conditions
- Imaging Studies: Doppler ultrasound (DVT assessment), CT/MRI (to evaluate arterial or other organ thrombosis), or echocardiography (cardiac manifestations) based on clinical presentation
- D-Dimer: To assist in evaluating suspected thrombotic events
- Tissue Plasminogen Activator (tPA) Resistance Testing: May be performed in specialized centers for additional thrombotic risk stratification
- Monitoring Frequency: Patients on warfarin require INR monitoring monthly initially, then every 4-12 weeks; those on heparin need APTT monitoring; anticoagulation adherence critical for symptom-free management
Fasting Required?
- Fasting Required: No - Fasting is NOT required for the antiphospholipid syndrome panel
- Specimen Collection Requirements: - Blood draw can be performed at any time of day - Collected in appropriate anticoagulant tubes (typically citrate tubes for coagulation studies) - Patient should remain calm and seated for 5 minutes before blood draw - Avoid prolonged tourniquet application (less than 1 minute) to prevent hemoconcentration
- Medications to Avoid: - Warfarin and other anticoagulants should NOT be stopped (unless specifically instructed by physician) - Antiplatelet agents (aspirin, clopidogrel) should continue normally - No specific medications need to be withheld before testing - Inform the laboratory and healthcare provider of ALL medications, especially anticoagulants
- Patient Preparation Instructions: - Wear loose-fitting clothing with easily accessible sleeves for blood draw - Bring a list of all current medications and supplements - Inform phlebotomist of any previous difficult blood draws or vein access issues - Stay well-hydrated but normal liquid intake is acceptable - Avoid smoking or vigorous exercise immediately before testing - Report if you have active infection or recent illness - For confirmatory testing, maintain consistent lifestyle (anticoagulation status, medications)
- Special Considerations: - Timing of initial test should be at least 12 weeks after acute thrombotic event or pregnancy complications - If results are weakly positive, repeat testing 6-12 weeks later for confirmation - Avoid testing during acute infection or malignancy if possible, as these can cause transient positivity - For pregnant patients, coordinate testing with obstetric care; continued anticoagulation may be necessary

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