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Antiphospholipid Testing and Outcome
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Ruiz-Irastorza and coworkers1 found the antiphospholipid syndrome (APS) to be associated with an unfavorable prognosis. Antiphospholipid syndrome is defined by consensus2; diagnosis requires clinical and laboratory criteria. We still ponder the impact of laboratory testing.
Tests for antiphospholipid antibodies (aPL) have substantial interassay and interlaboratory variability.3-6 Only a minority of laboratories seem to agree on positive or negative test results, such as for anticardiolipin antibodies.6 Our limited knowledge on the clinical utility of the many different aPL assays has been recently reviewed.7 In view of such variability and uncertainty, what guidance can the clinician derive from aPL testing?
The patient cohort of Ruiz-Irastorza et al1 stands out in size and duration of follow-up. This precious database may shed light on the impact of aPL testing. Do survival curves differ between those with thrombotic complications, irrespective of aPL status, and those fulfilling criteria of APS?
The multivariate regression analysis1 included . . . [Full Text of this Article]
Christoph Pechlaner, MD;
Christian J. Wiedermann, MD
Correspondence: Dr Pechlaner, Department of Internal Medicine, Innsbruck University Hospital, Anichstr 35, A-6020 Innsbruck, Austria (christoph.pechlaner@uibk.ac.at).
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