title: Does the anti-beta2-glycoprotein I antibody provide additional information in patients with thrombosis?
abstract: OBJECTIVE
  To investigate whether the anti-beta(2)-glycoprotein I (anti-beta(2)GPI) antibody may provide additional information in patients with thrombosis in conjunction with the lupus anticoagulant (LAC) or anticardiolipin (aCL) antibody.
  
  
  METHODS
  We selected 235 patients whose plasma were tested for the presence of all three antiphospholipid (aPL) antibodies (LAC, aCL, and anti-beta(2)GPI) and were positive for at least one aPL antibody from January 2000 to December 2001. The LAC test was performed using dilute activated thromboplastin time reagent (dAPTT) and dilute Russell viper venom time reagent (dRVVT). ACL (IgG/IgM) and anti-beta(2)GPI (IgG/IgM) were detected by enzyme-linked immunosorbent assay (ELISA). Clinical data were collected and analysed in all patients with aPL antibody.
  
  
  RESULTS
  Of the 235 patients with aPL, thrombosis was detected in 76 patients (28.0%). Of the 76 patients with thrombosis, 29 were positive for LAC, 9 for aCL, 7 for anti-beta(2)GPI, 3 for LAC+aCL, 9 for aCL+anti-beta(2)GPI, 11 for LAC+anti-beta(2)GPI, and 8 for LAC+aCL+anti-beta(2)GPI. The rate of thrombosis was significantly different (p=0.01) among single positive patients (45/163, 27.6%), double positive patients (23/60, 38.3%), and triple positive patients (8/12, 66.7%). In single positive patients, the rate of thrombosis was highest in LAC positive patients (29/85, 34.1%). In double positive patients, the LAC+anti-beta(2)GPI positive group (11/24, 45.8%) and aCL+anti-beta(2)GPI positive group (9/22, 40.9%) had higher rates of thrombosis than the LAC+aCL positive group (3/14, 21.4%).
  
  
  CONCLUSIONS
  Single positivity for anti-beta(2)GPI explained 9.2% of thrombotic events in the absence of LAC or aCL. Double or triple positivity for aPLs were associated with a higher rate of thrombosis than single positivity for aPL. Our results suggest that anti-beta(2)GPI provides additional information in patients with thrombosis in conjunction with LAC or aCL.
authors.affiliation: Division of Allergy and Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-Dong, Songpa-Gu, Seoul 138-736, South Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Lee
authors.forename: Chang-Keun
authors.initials: CK
authors.lastname: Lee
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Lee
authors.forename: Son Mi
authors.initials: SM
authors.lastname: Chung
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Kim
authors.forename: You Sook
authors.initials: YS
authors.lastname: Cho
authors.forename: Bin
authors.initials: B
authors.lastname: Yoo
authors.forename: Hee-Bom
authors.initials: HB
authors.lastname: Moon
mesh_terms: D017153:Antibodies, Anticardiolipin / Q000097:blood; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D001323:Autoantibodies / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D006023:Glycoproteins / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D010314:Partial Thromboplastin Time; D015203:Reproducibility of Results; D013927:Thrombosis / Q000097:blood / Q000276:immunology*; D053482:beta 2-Glycoprotein I
chemical_list: D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D001323:Autoantibodies; D015415:Biomarkers; D006023:Glycoproteins; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D016682:Lupus Coagulation Inhibitor; D053482:beta 2-Glycoprotein I