Comparison of serum markers for thrombophilia and autoimmune disease in reproductive age women with and without false positive rapid plasma reagin tests.
OBJECTIVE
The rapid plasma reagin test (RPR) is performed frequently in clinical practice, particularly among reproductive age women. The phenomenon of the biologic false positive RPR is well-recognized, but its clinical significance is poorly characterized. Our objective was to assess the relationship between the false positive RPR and several established clinical and biological markers for thrombophilia and/or autoimmune disease.


METHODS
We conducted a clinic-based, case-control study of 41 healthy, reproductive age women with history of a biologic false positive RPR and 30 control women with a negative RPR to assess the relationship between the false positive RPR and several established clinical and biological markers for thrombophilia and/or autoimmune disease. We used t-tests and constructed frequency tables for case-control comparisons.


RESULTS
Cases were significantly more likely than controls to have lupus anticoagulant present in serum, have a positive ANA, and a positive ANA with a titer of 1:320 or greater. Cases were also more likely to be positive for anticardiolipin antibodies and have a prolonged activated partial thromboplastin time, but the CIs for those point estimates included the null value. Eight participants tested positive for both lupus anticoagulant and ANA. All eight were in the case group.


CONCLUSIONS
These results suggest that the RPR test might be used to identify a subset of women who warrant further testing for autoimmune and/or thromboembolic disease.
Swica
Yael
Y
Gynuity Health Projects and Center for Family and Community Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA. yds3@columbia.edu
Westhoff
Carolyn
C
D000293:Adolescent; D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood; D000974:Antibodies, Antinuclear / Q000097:blood; D001327:Autoimmune Diseases / Q000097:blood* / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011935:Reagins / Q000097:blood*; D019851:Thrombophilia / Q000097:blood* / Q000276:immunology; D055815:Young Adult
D017153:Antibodies, Anticardiolipin; D000974:Antibodies, Antinuclear; D015415:Biomarkers; D011935:Reagins