ANTI PHOSPHOLIPID ANTIBODY IgM- APLA
Pre-test preparation or requirements
• Sample can be drawn at any time. No fasting or special preparation required.
• Sample should taken in plain vial.
0- 10 U/ml
Significance of test
Anti phospholipid syndrome (APS, Hughes Syndrome) is a systemic autoimmune disease that causes thromboses, recurrent miscarriage, and intrauterine fetal death. Clinical symptoms are accompanied by the occurrence of specific auto-antibodies that are detectable in the blood of patients with APS. These antibodies bind to phospholipids like cardiolipin, or phospholipid-binding proteins like beta-2-glycoprotein I. Laboratory tests thus play an important role in the diagnosis of the disease. The Scientific and Standardization committee of the International Society on Thrombosis and Hemostasis defined clinical criteria and diagnostically relevant laboratory parameters in the Sapporo Criteria for the classification of anti phospholipids syndrome, published in 1999. These were revised and updated in 2006 and 2012. They include the following laboratory parameters:
Detection of lupus anticoagulant (lA) in the plasma twice in the space of twelve weeks, according to the guidelines of the International Society on Thrombosis and Hemostasis.
Elevated anti-cardiolipin titre (IgG and/or IgM) in the blood. The values must be determined on two occasions at least two occasions at least twelve weeks apart using standardized ELISA tests for beta-2-glycoprotein I dependent cardiolipin antibodies.
Elevated beta-2-glycoprotein I antibody titre (IgG and/or IgM). The values must be determined on two occasions at least twelve weeks apart. Detection is performed by means of a standardized ELISA test.
The diagnosis of APS is considered as confirmed when at least one clinical and one of the laboratory criteria are fulfilled. In primary APS auto-antibodies against phospholipids appear independently, while in secondary APS phospholipid antibodies are detected in conjunction with other autoimmune disease, such as lupus erythematosus, rheumatoid arthritis, or Sjogren;s syndrome. Phospholipid antibodies are detectable in only 1-5 % of healthy individuals, but they are found in 16-35 % of lupus patients. The presence of anti-cardiolipin antibodies in systemic lupus erythematosus (SLE) can be related to the development of thrombosis and thrombocytopenia. In gynaecology they are supposed to cause intrauterine death or recurrent abortion. Furthermore, anti-cardiolipin antibodies have been detected in neurological disorders like cerebrovascular insufficiency, cerebral ischemia, epilepsy or chorea. Anti-cardiolipin autoantibodies occur in the immunoglobulin classes IgG, IgM or IgA. The determination of IgM antibodies is a valuable indicator in the diagnosis of beginning autoimmune diseases, whereas IgG antibodies are present in progressive stages of manifested autoimmune diseases, disorders.