C-reactive protein level as a predictor of transient vs. sustained anticardiolipin antibody positivity.
The antiphospholipid (APLA) syndrome is defined as the occurrence of venous or arterial thromboembolism or recurrent fetal loss in patients with a positive anticardiolipin (aCL) or lupus anticoagulant test on two occasions, 3 months apart. In this study, we sought to determine whether the level of C-reactive protein (CRP), a non-specific inflammatory marker, at the time of the initial positive aCL test is a predictor of the transient vs. sustained nature of the aCL. Patients with a positive aCL antibody test underwent high sensitivity (hs) CRP testing. A repeat aCL antibody assay was performed on a serum sample obtained 3-4 months later. The positive and negative predictive values of the hs-CRP assay as a predictor of the second aCL result were calculated and correlation between the hs-CRP result and second aCL result was determined. Fifty-four consecutive patients with a positive aCL test were studied. Forty-two had a positive aCL-2. The predictive value of a negative CRP test for a positive aCL-2 was found to be 82.5% (33 of 42 patients). A positive CRP was able to predict a negative aCL-2 in 35.7% of cases (nine of 14 patients). Our results suggest that the hs-CRP test may be useful in the assessment of patients with a positive aCL antibody test. A concurrently performed negative hs-CRP test result may be useful in making diagnostic and therapeutic decisions.
Twito
Orit
O
Department of Internal Medicine A, Meir Hospital, Kfar Saba and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Reshef
Tamar
T
Ellis
Martin H
MH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017153:Antibodies, Anticardiolipin / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D019937:Diagnostic Techniques and Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013997:Time Factors
D017153:Antibodies, Anticardiolipin; D002097:C-Reactive Protein