Journal article
Do patients followed in anticoagulation clinics for antiphospholipid syndrome meet criteria for the disorder?
Thrombosis and haemostasis, Vol.94(3), pp.548-554
09/2005
DOI: 10.1160/TH04-11-0756
PMID: 16268471
Abstract
Although specific criteria for diagnosing the antiphospholipid syndrome (APS) exist (the Sapporo Criteria), most physicians are not aware these include repeat testing and documentation of either a lupus anticoagulant or medium to high levels of anti-cardiolipin antibody. Incorrect diagnosis of APS may result in unnecessary long-term anticoagulation. The purpose of this study was to determine the clinical and serological characteristics of patients being treated for APS and concordance with published criteria. This cross-sectional study identified APS patients who were being treated with warfarin at one of three university-based anticoagulation clinics. Levels of anticardiolipin antibody were classified as low-positive if abnormal but < 40 GPL/MPL units and medium/high-positive if > or = 40 units. Strength of meeting Sapporo criteria was graded as definite, possible, and not meeting criteria. Of 103 cases, 97 had clinical and laboratory data available. Only 10 cases (10%, 95% Confidence Interval 5 - 19) met criteria for definite APS, 16 (16%, 10 - 26) had a possible diagnosis, and 71 (73%, 63 - 81) did not meet criteria. Of 70 cases that had abnormal anticardiolipin antibody results, only 32 (46%, 34 - 58) had medium/high-positive levels. Repeat laboratory testing was performed in only 49 cases (51%, 40 - 61). We conclude that few patients treated forAPS met Sapporo criteria. Abnormal levels of anticardiolipin antibody were frequently in the low-positive range, and repeat testing was often absent. A quality improvement program that includes review of cases referred for chronic anticoagulation care is recommended to ensure appropriate testing and treatment of patients with suspected APS.
Details
- Title: Subtitle
- Do patients followed in anticoagulation clinics for antiphospholipid syndrome meet criteria for the disorder?
- Creators
- Andrew S Dunn - Division of General Medicine, Mount Sinai School of Medicine, 1470 Madison Ave, Box 1087, New York, NY 10029, USA. andrew.dunn@mountsinai.orgPeter KaboliThorvardur HalfdanarsonHappy ChanRod HubertSeth RosenRichard H White
- Resource Type
- Journal article
- Publication Details
- Thrombosis and haemostasis, Vol.94(3), pp.548-554
- DOI
- 10.1160/TH04-11-0756
- PMID
- 16268471
- ISSN
- 0340-6245
- eISSN
- 2567-689X
- Grant note
- name: AstraZeneca Pharmaceuticals
- Language
- English
- Date published
- 09/2005
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9984094721402771
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