Diagnosis of Lupus Anticoagulants
Antiphospholipid antibodies (APA) are a family of immunoglobulins which habe been defined by in vitro laboratory tests [1,2]. The immunoglobulin may be of IgG, IgM, or IgA isotypes. In the majority of patients, they are polyclonal although occasionally monoclonal APAs are identified in patients with hematologic malignancies . Often, within an individual patient, there may be a mixture of isotypes with differing reactivity toward negatively charged phospholipids. Recent observations would suggest that this group of antibodies may, in fact, be misnamed. There is increasing evidence that the antigenic target(s) may be a complex(es) of phospholipid and protein(s) [4, 5]. For example, anticardiolipin antibodies (ACA) require the presence of a plasma protein, beta2 glycoprotein I (apolipoprotein H) for optimal reactivity in a solid phase ELISA assay [6,7].
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