Objective: We aimed to analyze the prevalence of non-criteria anti-phospholipid (aPL) antibodies and their role in the diagnosis, treatment and prognosis in a cohort of patients with clinical features consistent with a diagnosis of antiphospholipid syndrome (APS), but persistently negative for criteria aPL-anti-cardiolipin antibodies (aCL), anti-β2-glycoprotein I antibodies (aβ2-GPI), and lupus anticoagulant (LA) - named seronegative APS (SN-APS). Methods: Sera from SN-APS patients were tested for aCL by TLC-immunostaining, anti-vimentin/cardiolipin (aVim/CL) and anti-phosphatidylserine/prothrombin (anti-PS/PT) by ELISA. Control groups of our study were APS patients and healthy controls. Results: We enrolled 114 consecutive SN-APS patients, 69 (60.5%) resulted positive for at least one non-criteria test in two occasions 12 weeks apart. Among the persistently positive patients to these tests, 97% resulted positive for aCL by TLC-immunostaining, 52.3% for aVim/CL and 17.4% for aPS/PT. SN-APS patients with double positivity (aCL by TLC-immunostaining and aVim/CL) showed a likelihood positive ratio of 8 to present mixed thrombotic and obstetrical features. Among SN-APS patients tested positive, after the therapeutic changes, 3 cases of recurrent thrombosis were observed [median follow-up 41 months (IQR 39.5)]. Twenty pregnancies were recorded in 17 SN-APS patients after the detection of unconventional aPL and 12 of them (60%) experienced a good outcome under conventional treatment for APS. Conclusions: This is the largest monocentric study demonstrating that aCL tested by TLC-immunostaining and aVim/CL can detect aPL positivity in SN-APS. It may encourage clinicians to monitoring and providing adequate targeted therapy, which improve SN-APS prognosis.

“Non-criteria antiphospholipid antibodies”: bridging the gap between seropositive and seronegative Antiphospholipid Syndrome / Truglia, Simona; Mancuso, Silvia; Capozzi, Antonella; Recalchi, Serena; Riitano, Gloria; Longo, Agostina; De Carolis, Sara; Spinelli, FRANCESCA ROMANA; Alessandri, Cristiano; Ceccarelli, Fulvia; De Carolis, Caterina; Misasi, Roberta; Sorice, Maurizio; Conti, Fabrizio. - In: RHEUMATOLOGY. - ISSN 1462-0324. - (2022). [10.1093/rheumatology/keab414]

“Non-criteria antiphospholipid antibodies”: bridging the gap between seropositive and seronegative Antiphospholipid Syndrome

Simona Truglia
;
Silvia Mancuso;Antonella Capozzi;Serena Recalchi;Gloria Riitano;Agostina Longo;Francesca Romana Spinelli;Cristiano Alessandri;Fulvia Ceccarelli;Roberta Misasi;Maurizio Sorice;Fabrizio Conti
2022

Abstract

Objective: We aimed to analyze the prevalence of non-criteria anti-phospholipid (aPL) antibodies and their role in the diagnosis, treatment and prognosis in a cohort of patients with clinical features consistent with a diagnosis of antiphospholipid syndrome (APS), but persistently negative for criteria aPL-anti-cardiolipin antibodies (aCL), anti-β2-glycoprotein I antibodies (aβ2-GPI), and lupus anticoagulant (LA) - named seronegative APS (SN-APS). Methods: Sera from SN-APS patients were tested for aCL by TLC-immunostaining, anti-vimentin/cardiolipin (aVim/CL) and anti-phosphatidylserine/prothrombin (anti-PS/PT) by ELISA. Control groups of our study were APS patients and healthy controls. Results: We enrolled 114 consecutive SN-APS patients, 69 (60.5%) resulted positive for at least one non-criteria test in two occasions 12 weeks apart. Among the persistently positive patients to these tests, 97% resulted positive for aCL by TLC-immunostaining, 52.3% for aVim/CL and 17.4% for aPS/PT. SN-APS patients with double positivity (aCL by TLC-immunostaining and aVim/CL) showed a likelihood positive ratio of 8 to present mixed thrombotic and obstetrical features. Among SN-APS patients tested positive, after the therapeutic changes, 3 cases of recurrent thrombosis were observed [median follow-up 41 months (IQR 39.5)]. Twenty pregnancies were recorded in 17 SN-APS patients after the detection of unconventional aPL and 12 of them (60%) experienced a good outcome under conventional treatment for APS. Conclusions: This is the largest monocentric study demonstrating that aCL tested by TLC-immunostaining and aVim/CL can detect aPL positivity in SN-APS. It may encourage clinicians to monitoring and providing adequate targeted therapy, which improve SN-APS prognosis.
Antiphospholipid syndrome; SN-APS; TLC-immunostaining; aVim/CL; prognosis.
01 Pubblicazione su rivista::01a Articolo in rivista
“Non-criteria antiphospholipid antibodies”: bridging the gap between seropositive and seronegative Antiphospholipid Syndrome / Truglia, Simona; Mancuso, Silvia; Capozzi, Antonella; Recalchi, Serena; Riitano, Gloria; Longo, Agostina; De Carolis, Sara; Spinelli, FRANCESCA ROMANA; Alessandri, Cristiano; Ceccarelli, Fulvia; De Carolis, Caterina; Misasi, Roberta; Sorice, Maurizio; Conti, Fabrizio. - In: RHEUMATOLOGY. - ISSN 1462-0324. - (2022). [10.1093/rheumatology/keab414]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1555136
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