Clinical Relevance of Antiphospholipid Antibodies in Deep Venous Thrombosis

Abstract

D iagnosis of APS is quite challenging. The Clinical and serological classification criteria for APS were first formulated and published in 1999 and called Sapporo criteria. These criteria performed poorly due to many reasons among which there was no clear cut offs for the medium or high titer of ACL IgG& the issue of difference in timing of laboratory testing in relation to the clinical event was not clarified adequately. The need for new criteria led to Sydney 2006 where a panel of experts met at a workshop held during ISTH and set their recommendations; where clear cut offs for ACL IgG were defined, β2GPI IgG was included, the timing of laboratory testing with respect to the clinical thromboticevent has been better defined along with other recommendations. The year 2009 came along with the new update for LA testing & strict guidelines. In which, LA coagulation testing should be done through 3 step procedure; screening, mixing experiment, confirmatory testing. Both APTT-LA and dRVVT tests should be performed together. It was not till 2014 where the guidelines for solid phase assays were published. Both guidelines should be adopted by all laboratories.