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2014; 60(2):181-186
S
UMMARY
Antiphospholipid syndrome: a clinic and laboratorial
challenge
Antiphospholipid syndrome (APS) is an acquired auto-
immune thrombophilia characterized by the presence of
a heterogeneous family of antibodies that bind to plas-
ma proteins with afinity for phospholipid surfaces. The
two major protein targets of antiphospholipid antibod-
ies (APA) are prothrombin and
β
2
-glycoprotein I (
β
2
GP1).
APS leads to aprothrombotic state, and it is characterized
by the occurrence of arterial, venous or microvascular
thrombosis or recurrent fetal loss. The diagnosis of APS
is based on a set of clinical criteria and the detection of
plasma lupus anticoagulant (LA), anticardiolipin anti-
bodies (ACA) or anti-
β
2
GP1. Although laboratory tests
are essential for APS diagnosis, these tests have limita-
tions associated with the robustness, reproducibility and
standardization. The standardization of diagnostic tests
for APA detection has been a challenge and a variety of
results have been obtained using different commercial
kits and in-house techniques. An increased sensitivity of
the ELISA kits for detection of ACA effectively contrib-
uted to the APS diagnosis. However, the lack of speciic-
ity associated with a high number of false-positive results
is a clinical and laboratory challenge, since such results
may lead to wrong clinical decisions, such as prescription
of oral anticoagulant, leading to bleeding risk. Further-
more, clinicians often are not familiar with these tests
and have dificulty to interpret them. Thus, interaction
between clinical and laboratory personnel are required
to ensure the correct SAAF test interpretation.
Key words:
antiphospholipid syndrome; clinical diagno-
sis; laboratorial tests; pre-analytical phase.
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