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Coagulation

Coagulation laboratory tests

Anticardiolipin antibodies

Reviewer: Jeremy Parsons, M.D. (see Reviewers page)
Revised: 19 June 2012, last major update June 2012
Copyright: (c) 2002-2012, PathologyOutlines.com, Inc.

General
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● One of the two main types of antiphospholipid antibodies (other is lupus anticoagulant) often seen in conjunction with beta2-glycoprotein antibodies

Indications:
● Patients with venous thromboembolism (particularly if no family history or associated with autoimmune disease)
● Unexplained stroke (young person or autoimmune disease), cerebral venous thrombosis, recurrent or late pregnancy loss
● Test may be considered for arterial thrombosis, particularly in young patient or no documented atherosclerosis

Specimen:
● Serum (red top)

Methodology:
● ELISA test to recognize proteins (not actually cardiolipin) bound to a microtiter plate
● Tests for anti-prothrombin and anti-beta2-GPI antibodies have had limited prospective studies
● IgG recommended to evaluated hypercoagulability (risk with IgM or IgA antibodies is uncertain)
● Increased titers are most closely associated with hypercoagulability
● 200-400x more sensitive than VDRL, but patient with syphilitic infection may have positive anticardiolipin antibody test results
● High sensitivity plates have greater antigenic density on microtiter plate, may be irradiated for greater antigenic density and to facilitate bivalent bonding of plasma antibodies
● 62% positivity in patients with SLE or other autoimmune results
● To demonstrate antibody persistence, positive test must be confirmed by repeat testing after 6 weeks
● Transient antibodies are not strongly associated with thrombosis

Additional references
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● Arch Pathol Lab Med 2002;126:1424, Lancet 2010;376:1498

End of Coagulation > Coagulation laboratory tests > Anticardiolipin antibodies

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