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Blood tests for antiphospholipid antibodies

There are three main blood tests used to diagnose APS and they are all looking for antiphospholipid antibodies (aPL):

  • Anticardiolipin antibodies (aCL)
  • Lupus anticoagulant (LA)
  • Anti-beta2-glycoprotein-1 (anti-B2GP1)

The result of the blood clotting lupus anticoagulant test is either negative or positive, while the results of the other two specific antibody tests are given in figures.

The reason for the three tests is that they measure aPL in different ways and many patients are positive for just one test, although some can be triple positive. So this means that one test alone could miss the diagnosis. The most common test to come back positive is the aCL, then the LA and finally the anti-B2GP1. People who have more than one positive test are considered at higher risk.

It is usually advisable to repeat the blood tests as one positive test for aPL does not necessarily mean that a person has APS. This is because harmless aPL can be detected in the blood for brief periods in association with a wide variety of infections such as chickenpox, and certain drugs including antibiotics and some blood pressure tablets. For this reason, the tests should be repeated typically after 12 weeks. If someone has only one positive test and it quickly becomes negative again, then it is unlikely they have APS.

Anticardiolipin antibodies – aCL

In this test, the chemical known as anticardiolipin is coated on a glass or plastic surface and the test serum is added. The stronger the binding of the blood serum, the higher the level of aCL.

Lupus Anticoagulant – LA

This inaccurate and confusing name is given to the second test for APS. Lupus anticoagulant is in fact a double misnomer and is NOT a test for lupus and is not an anticoagulant. Unsurprisingly, many people assume they have lupus when they are told they have tested positive for the LA but this is not true – they are testing positive for the aPL associated with APS.

Anti-beta2-glycoprotein-1

The science behind the thrombotic tendency in APS is always improving and moving on – thanks to the ongoing research around the world.

It was soon discovered that for aPL to do their worst, binding to a protein was required. One such protein was called anti-beta2-glycoprotein-1. Some laboratories now include an assay for anti-B2GP1 for completeness and extra precision when testing, and it is usually tested on patients who have obvious symptoms of APS but have consistently negative aCL and LA test results.

TThe anti-B2GP1 can be tested if a patient is already taking anticoagulants such as warfarin, heparin, rivaroxaban or aspirin but, due to the complexity of the test, it is not yet widely available in all hospitals and laboratories.

How do I get tested?

If you are displaying symptoms of APS find out how you can get tested via your GP or by private screening.

FAQs

View our comprehensive list of Frequently Asked Questions which will give you an overview of living with and understanding APS.

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