Autoantibodies to prothrombin and phosphatidylserine/prothrombin-complexes: do they contribute to the serodiagnosis of primary and secondary anti-phospholipid syndrome?
The diagnostic and clinical relevance of Ab to pure and phosphatidylserine-complexed prothrombin for primary and secondary APS was investigated in a total of 357 patients with (n = 169) and without (n = 188) connective tissue diseases. The overall frequency of anti-prothrombin Ab in sAPS, pAPS and patients without APS-related symptoms were found to be 50.0, 37.5 and 22.0%, respectively. From a total of 72 anti-prothrombin-positive samples, 12.5% were specific for pure prothrombin, 31.9% for phosphatidylserine/prothrombin-complexes and 55.6% recognized both antigenic forms. The simultaneous occurrence of other anti-phospholipid Ab was observed in 84% of all sera. Both types of anti-prothrombin Ab are significantly associated with lupus anticoagulant activity, but only Ab to pure prothrombin display such a relationship to clinical manifestations of APS. Based on these results, it cannot be recommended at present to include anti-prothrombin assays in the routine procedure for the serodiagnosis of APS. However, patients negative for lupus anticoagulant and typical APS-related anti-phospholipid Ab should be tested for anti-prothrombin reactivity, favoring, mainly due to its higher specificity, the ELISA containing pure prothrombin as antigen.
Jaekel
H P
HP
Institute of Laboratory Diagnostics, Microbiology and Transfusion Medicine, Dietrich Bonhoeffer Clinical Centre, Neubrandenburg, Germany. LAB@dbk-nb.de
Trabandt
A
A
Schmid
D
D
Grobe
N
N
Müller
E W
EW
Ziutelis
V
V
Kaskel-Paul
S
S
Höh
H
H
Bauer
B
B
Sudik
R
R
Baldauf
A
A
Werle
E
E
D000328:Adult; D000368:Aged; D016736:Antiphospholipid Syndrome / Q000175:diagnosis / Q000276:immunology*; D001323:Autoantibodies / Q000276:immunology*; D003429:Cross Reactions / Q000276:immunology; D005260:Female; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010718:Phosphatidylserines / Q000276:immunology*; D011516:Prothrombin / Q000276:immunology*; D012698:Serologic Tests
D001323:Autoantibodies; D016682:Lupus Coagulation Inhibitor; D010718:Phosphatidylserines; D011516:Prothrombin