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Annexin-A5 resistance and non-criteria antibodies for the diagnosis of seronegative antiphospholipid syndrome

  • Théo Ghelfenstein Ferreira
  • François Delhommeau
  • Catherine Johanet
  • Grigorios Gerotziafas
  • Marie Bornes
  • Jonathan Cohen
  • Gilles Kayem
  • Olivier Fain
  • Virginie Planche
  • Arsene MékinianEmail author
Brief Report

Abstract

In this study, we aimed to analyze the value of annexin-A5 anticoagulant ratio (A5R) and non-criteria antibodies for the diagnosis of APS in patients with clinical seronegative APS. Three groups were defined, including 21 seronegative APS patients with unexplained obstetrical adverse events or thrombosis history, 15 confirmed APS patients with triple aPL positivity, and a control group of 20 healthy patients without any history of thrombosis or pregnancy complications. Seronegative APS patients have similar levels of A5R in comparison to healthy controls (202% [171%–238%] versus 191% [178%–221%]; p = 0.65), whereas triple-positive APS patients have significantly more reduced A5R in comparison to both seronegative and healthy patients (149% [138%–158%] versus 202% [171%–238%] and 191% [178%–221%], respectively, p < 0.001). The non-criteria aPL were found in 24% of seronegative APS: anti-PE IgM in 3 cases (14%) and anti-PS/PT IgG and anti-PS/PT IgM in 1 (5%) case each. The frequency of non-criteria APL was significantly more frequent in comparison to healthy controls (p = 0.048). All triple-positive APS patients have at least one non-criteria aPL, and the non-criteria aPL were significantly more frequent in these patients compared to seronegative APS and healthy controls (p < 0.001). Whereas A5R levels do not allow to discriminate seronegative APS from healthy controls, our results demonstrate that non-criteria aPL can help to APS diagnosis in clinical seronegative APS.

Key points

Annexin-A5 resistance testing does not help for the diagnosis of seronegative APS.

The non-criteria antiphospholipid antibodies can contribute to APS diagnosis in patients without conventional antibodies.

Keywords

Annexin-A5 Annexin-A5 resistance Antiphospholipid antibodies Antiphospholipid syndrome Non-criteria antibodies Seronegative 

Notes

Compliance with ethical standards

Disclosures

None.

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Copyright information

© International League of Associations for Rheumatology (ILAR) 2020

Authors and Affiliations

  • Théo Ghelfenstein Ferreira
    • 1
  • François Delhommeau
    • 1
  • Catherine Johanet
    • 1
  • Grigorios Gerotziafas
    • 2
  • Marie Bornes
    • 3
  • Jonathan Cohen
    • 3
  • Gilles Kayem
    • 4
  • Olivier Fain
    • 5
  • Virginie Planche
    • 1
  • Arsene Mékinian
    • 5
    Email author
  1. 1.Sorbonne Université, Service de Hématologie biologique, APHP, Hopital SAint Antoine,ParisFrance
  2. 2.Service d’hématologie biologiqueHôpital TenonParisFrance
  3. 3.Service de Gynécologie Obstétrique et Médecine de la ReproductionHôpital TenonParisFrance
  4. 4.Service de Gynécologie ObstétriqueHôpital Armand-TrousseauParisFrance
  5. 5.Sorbonne Université, Service de Médecine Interne, APHP SAint AntoineParisFrance

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