Abstract
Diagnosis of antiphospholipid syndrome (APS) lies in the recognition of antiphospholipid
antibodies (aPL). As standardization of tests for the detection of aPL is far from
being optimal and reference material is not available, inappropriate diagnoses of
APS are not unusual. In the last few years, the concept of triple test positivity
has emerged as a useful tool to identify patients with APS. Clinical studies on patients
and carriers of triple positivity clearly show that these individuals are at high
risk of thromboembolic events and pregnancy loss. Moreover, triple positivity arises
from a single (probably pathogenic) antibody directed to domain 1 of β2-glycoprotein I, a protein whose function is still unknown. Studies on homogenous
group of patients with single or double positivity are scant, and uncertainties arise
on their association with clinical events. Promising but undetermined results come
also from the determination of antibodies directed to phosphatidylserine/prothrombin
complex. Interpretation of laboratory profile in APS is challenging, and the collaboration
between clinical pathologists and clinicians is highly desirable.
Keywords
cardiolipin - β
2-glycoprotein I - antibodies - lupus anticoagulant - thrombosis
