Screening for cardiolipin antibodies is used in the investigation of patients with antiphospholipid syndrome.
Antibodies against cardiolipin are the most common form of antiphospholipid antibodies. Antibodies play an important role in the blood clotting process. When autoantibodies (anti-cardiolipin antibodies, or ACA) are formed against cardiolipin, the patient has an increased risk of developing recurrent thrombosis. There are three types of anti-cardiolipin antibodies: IgG, IgM, and IgA. Screening for ACA antibodies is used to determine the cause of thrombosis, thrombocytopenia, recurrent (repeated) miscarriages, and in the evaluation of patients with systemic lupus erythematosus. Present or past infection with syphilis can give a false-positive result.
The diagnosis of antiphospholipid syndrome requires that at least 1 clinical and 1 laboratory criterion be met. Clinical criteria include vascular thrombosis (arterial or venous in any organ or tissue) and pregnancy complications (unexplained fetal death, premature birth, severe preeclampsia, or placental insufficiency). Other clinical manifestations that are often associated with the syndrome, such as heart valve disease, peliosis hepatis, thrombocytopenia, nephropathy, neurological symptoms, however, are not included in the diagnostic criteria. Laboratory criteria for the diagnosis of the antiphospholipid syndrome are the presence of lupus anticoagulant, the presence of IgG and/or IgM cardiolipin antibodies, and the presence of IgG and/or IgM antibodies against beta-2-GP1. All antibodies should be positive for 2 or more times at least 12 weeks apart. Antibodies against beta-2-GP1 are somewhat more specific (but less sensitive) for the diagnosis of antiphospholipid syndrome. IgA antibodies against cardiolipin and beta-2-GP1 are not part of the laboratory criteria because of their low specificity.
Possible Interpretations of Pathological Values
Increase: Anti-phospholipid syndrome, idiopathic thrombocytopenic purpura, psoriatic arthritis, rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus. Medications: Antiepileptic, antibiotics, hydralazine, oral contraceptives, phenothiazines, procainamide.
Laboratory test results are the most important parameter for the diagnosis and monitoring of all pathological conditions. 70%-80% of diagnostic decisions are based on laboratory tests. The correct interpretation of laboratory results allows a doctor to distinguish "healthy" from "diseased".
Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be interpreted in relation to each individual case and family history, clinical findings, and the results of other laboratory tests and information. Your personal physician should explain the importance of your test results.
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