title: Autoantibodies to prothrombin and phosphatidylserine/prothrombin-complexes: do they contribute to the serodiagnosis of primary and secondary anti-phospholipid syndrome?
abstract: 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.
authors.affiliation: Institute of Laboratory Diagnostics, Microbiology and Transfusion Medicine, Dietrich Bonhoeffer Clinical Centre, Neubrandenburg, Germany. LAB@dbk-nb.de
authors.forename: H P
authors.initials: HP
authors.lastname: Jaekel
authors.forename: A
authors.initials: A
authors.lastname: Trabandt
authors.forename: D
authors.initials: D
authors.lastname: Schmid
authors.forename: N
authors.initials: N
authors.lastname: Grobe
authors.forename: E W
authors.initials: EW
authors.lastname: Müller
authors.forename: V
authors.initials: V
authors.lastname: Ziutelis
authors.forename: S
authors.initials: S
authors.lastname: Kaskel-Paul
authors.forename: H
authors.initials: H
authors.lastname: Höh
authors.forename: B
authors.initials: B
authors.lastname: Bauer
authors.forename: R
authors.initials: R
authors.lastname: Sudik
authors.forename: A
authors.initials: A
authors.lastname: Baldauf
authors.forename: E
authors.initials: E
authors.lastname: Werle
mesh_terms: 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
chemical_list: D001323:Autoantibodies; D016682:Lupus Coagulation Inhibitor; D010718:Phosphatidylserines; D011516:Prothrombin