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🧪 Cardiolipin Antibody – IgM

Parameter	Details
Sample Type	Blood (Serum)
Fasting Required	🚫 Not required
Main Systems	Immune, vascular, and reproductive systems
Purpose	Screening and diagnosis of Antiphospholipid Syndrome (APS), particularly in patients with unexplained blood clots, pregnancy loss, or autoimmune disease

🔍 What Are Cardiolipin IgM Antibodies?

Cardiolipin is a phospholipid found in cell membranes, especially in mitochondria. IgM antibodies against cardiolipin are one of the three isotypes (IgG, IgA, IgM) that may be produced by the immune system in response to phospholipid-containing structures.

IgM antibodies are often produced earlier in the immune response and may be transiently elevated in infections. However, persistent elevation is significant for diagnosing APS when combined with clinical signs.

📈 Reference Range

Result (in MPL units)	Interpretation
< 12 MPL	Negative (normal)
12–20 MPL	Borderline
> 20 MPL	Positive – may indicate autoimmune activity

MPL units = IgM Phospholipid Units

🧪 When is ACL-IgM Ordered?

Clinical Situation	Purpose
✅ Recurrent pregnancy loss	Especially in 2nd or 3rd trimester
✅ Unexplained arterial or venous clots	Rule out antiphospholipid syndrome
✅ Stroke/TIA in young patients	May be autoimmune-related
✅ Suspected autoimmune disorders	Like SLE (Lupus) or mixed connective tissue disease
✅ Abnormal coagulation (prolonged APTT)	Part of work-up for lupus anticoagulant

⚠️ What Conditions Show Elevated IgM Cardiolipin Antibodies?

Condition	Relevance
Antiphospholipid Syndrome (APS)	Autoimmune condition with clotting and pregnancy loss
Systemic Lupus Erythematosus	Often coexists with APS
Infections (e.g., syphilis, TB)	May cause transient rise in IgM
Elderly or critically ill patients	Non-specific elevations

📉 Important Diagnostic Notes

IgM alone is not definitive for APS; must be persistent on two occasions ≥12 weeks apart.
Diagnosis of APS requires at least one clinical + one lab criterion:
- Clinical: Thrombosis or pregnancy morbidity
- Lab: Elevated IgG/IgM ACL, β2GP1 antibodies, or lupus anticoagulant

🔬 Other Tests Commonly Ordered With ACL-IgM

Test	Why
Cardiolipin IgG & IgA	Full antibody profile
Beta-2 Glycoprotein 1 (IgG/IgM)	Specific APS marker
Lupus Anticoagulant	Functional clotting test for APS
ANA and dsDNA	Screen for systemic lupus
APTT/PT/INR	Coagulation evaluation
Anti-β2GP1	Especially if IgG/IgM ACL is borderline

📋 Summary Table

Test Name	Cardiolipin Antibody (IgM)
Sample Type	Blood (serum)
Fasting Needed	No
Normal Range	<12 MPL units
Clinical Use	Evaluate APS, pregnancy loss, unexplained thrombosis
Paired With	IgG/IgA ACL, β2GP1 IgG/IgM, lupus anticoagulant
Repeat Test	Required after 12 weeks for APS confirmation

Cardiolipin Antibody (ACL) -IgM

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