Difficulties and controversies in biological diagnosis of antiphospholipidic syndromes of pregnancy
Keywords:
ANTIPHOSPHOLIPID SYNDROME, PREGNANCY COMPLICATIONSAbstract
There are difficulties and controversies in biological diagnosis of antiphospholipidic syndromes of pregnancy. Diagnosis in women with a history of suspicious antiphos-pholipidic syndromes is of great importance in order to indicate an adequate treatment.
The aims of this study were:
1. To compare the results of different laboratory techniques in a population of women referred for confirmation or rejection of a pregnancy antiphospholipidic syndrome;
2. To establish if the performance of more than one technique in a same patient increases the chance to achieve an accurate diagnosis.
Materials and methods: In 607 patients referred to the Specialized Center on Hemostasis Disorders and Thrombosis (CEAHT) that presented different obstetric complications, antiphospholipidic antibodies were measured using available commercial reagents (ACA and APA). In 407 of these patients the lupus anticoagulant (AL) was also determined.
Results: 102 (16%) patients showed at least one positive test confirmed by more than two different ways. The ACA (anticardiolipin antibodies) resulted positive in 78.4% followed by the APA, 29.4% (antibodies against a mixture of phospholipids) and the AL, showing a very low frequency of 8%. Only in 18.4% of the cases the coincidence of two or more techniques was observed.
Conclusion: It is advisable, according to these data, to perform at least two immunological techniques apart from AL, before confirming the absence of occurrence of an antiphospholipidic syndrome of pregnancy.
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