Cardiolipin Antibodies (ACA) IgG and IgM

Immunology

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Description

Anti-cardiolipin antibodies (ACA) are associated with anti-phospholipid syndrome, idiopathic spontaneous abortion and systemic lupus erythematosus (SLE). The international consensus statement clarifies that anti-phospholipid syndrome can be diagnosed with: vascular thrombosis (blood clots) in any organ or tissue or pregnancy event (one or more miscarriages after 10th week of gestation, three or more miscarriages before 10th week of gestation, or one or more premature births before 34th week of gestation due to eclampsia) and persistently positive IgG or IgM anti-phospholipid antibodies at moderate-high titer (>40 GPL or MPL U/mL), or moderate-to-high titer beta-2 glycoprotein antibodies [1]. Anti-cardiolipin antibodies should be positive on at two occasions at least 12 weeks apart. IgG anti-cardiolipin antibodies are the most prevalent and demonstrate the greatest clinical correlation. The significance of IgM anti-cardiolipin antibodies is uncertain [3]. ACA are frequently detected in syphilis, HIV infected patients and other viral, bacterial and parasitic infections but are not correlated with the thrombosis risk or haematological manifestations of anti-phospholipid syndrome [2].

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Indications

Anti-phospholipid syndrome (APL). Can be transiently elevated so recommend repeat at >12 weeks with concurrent lupus anticoagulant/drvvt.

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Sample Type

2mL Serum (Gel 5mL Yellow tube). Requests from outside Sheffield: Transport at ambient temperature via Royal Mail or Courier.

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Reference Range

IgG ACA:
<10 GPL U/mL = Negative
10-40 GPL U/mL = Weak positive
>40 GPL U/mL = Positive.
IgM ACA:
<10 MPL U/mL = Negative
10-40 MPL U/mL = Weak positive
>40 MPL U/mL = Positive.

Reference ranges manufacturer derived and verified in house.

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Turnaround Time

Within 5 days

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Testing Frequency

Weekly

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References

Tuthill JI, K Hamashta. Management of antiphospholipid syndrome. Journal of Autoimmunity. 2009. 33:92-98.Sene D, Piette JC, Cacoub P. Antiphospholipid antibodies, antiphospholipid syndrome and infections. Autoimmunity reviews. 2008. 7(4):272-277. [Ref 2]PRU Handbook of Autoimmunity. 4th Edition. 2007. [Ref 3].Miyakis S, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006. 4:295-306. [Ref 1]Lim W, Crowther MA, Eikelboom JW. Management of Antiphospholipid Antibody Syndrome; A systematic review. JAMA. 2006. 295(9):1050-1057.Marai I, et al. Anticardiolipin and anti-beta-2-glycoprotein I antibodies. Autoimmunity. 2005. 38(1):33-38.

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See Also

Beta 2 Glycoprotein IgG and IgM

Please note: the above information is subject to change and we endeavour to keep this website up to date wherever necessary.