The Diagnosis of the Antiphospholipid Syndrome in Our Medical University Center for the Year 2007.

The antiphospholipid syndrome (APS) is associated with arterial and venous thrombosis and with obstetrical complications. According to the recommendations published in 2006, the diagnosis of SAP requires at least one clinical manifestation and, at least, one abnormal laboratory test: lupus anticoagulant (LA), anti-cardiolipin antibodies (ACL) or anti-B2-Glycoprotein antibodies (anti-B2GP1). More, the abnormal test has to be repeated and still abnormal 3 months later. In this study, we evaluated the process leading to a diagnosis of APS in our hospital during a whole year period. The clinicians had previously received a copy of published recommendations.

We registered the identification number of all patients tested for 1 or more test (LA, ACL, anti-B2-GP1) in our laboratory during the year 2007. We then, retrospectively, analyzed the medical files of the patients who had their medical evaluation in our Center. We retained the following data: sex, age, symptoms at the presentation, final diagnosis, results of the specific tests for APS with the interval between the positive tests and the control tests.

During 2007, 331 patients were tested for APS in our laboratory. We analyzed the medical files of 259 patients, 184 women and 75 men, with a mean age of 43,9 years. The indications for testing were: venous thrombosis (36, 7%), arterial thrombosis (14,3%), obstetrical complications (15,7%), collagenosis (17%), prolonged TTPa (3,1%), others (13,9%). In the laboratory, we found 91 positive tests in 70 patients. For 5 patients, all the three tests were positive. Only 48 positive tests were controlled after a period of 6 to 12 weeks. In total, 24 patients had at least one positive and controlled test; from them, 10 had all the criteria for the APS and 13 had abnormal tests without the clinical criteria for the APS.

In this study, 3, 9% of tested patients had the diagnostic criteria for the APS. The indications for ordering the tests seemed adequate in 86% of the cases. Only 52.7% of the positive tests were controlled. We have modified our interpretation of the positive tests, suggesting a control after 3 months.

No relevant conflicts of interest to declare.