SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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C. Ottiger1 , L. Risch2 , A.R. Huber1

1Department of Laboratory Medicine, Kantonsspital Aarau, 5001 Aarau, Switzerland, 2Department of Intern Medicine, Akademisches Lehrkrankenhaus, 6800 Feldkirch, Austria

Anti-phospholipid antibodies are characterised through binding to proteins with an affinity for anionic phospholipids. Annexin V (AnxV) is a potent anticoagulant protein which interacts with the phospholipid-dependent Protein C pathway. Interference with AnxV function by anti-AnxV antibodies (-Ab) has been proposed as a cause of thrombosis. Anti-prothrombin (PT)-Ab were found in patients with positive lupus anticoagulans (LA) and bleeding complications. These antibodies hamper the conversion of FX by FIX and FVIII in the presence of phospholipids and calcium. Despite all these, the clinical relevance of anti-AnxV- and anti-PT-Ab in APS needs further exploration. Thus, 116 patients with different types of thrombophilia, e.g. DVT, foetal loss, phlebitis, SLE, catastrophic APS (1 case), were tested for the presence of anti-AnxV-IgG and anti-PT-IgG and -IgM with ELISA (Hyphen BioMed, Andrésy, France). 35 of these samples were positive for anti-cardiolipin and/or anti-beta2-glycoprotein-1 (>20 U/ml) and 36 were in the grey zone (10-20 U/ml), respectively. 1 sample was in the grey zone for LA only. Grey zone values of anti-PT-IgG and -IgM were obtained in anti-cardiolipin/beta2-glycoprotein positive samples in 1 and 5 cases, respectively. The patient with the catastrophic APS and the one patient with positive LA were in the grey zone for anti-PT-IgG. Only 1 of 116 patients presented a high value of anti-PT-IgG and was negative for the other parameters. The clinical picture of this patient consisted in venous thrombosis, recurrent foetal loss and status after Hodgkin disease. Anti-AnxV-IgG was negative in all 116 samples. In conclusion, our results indicate that the prevalence of positive anti-AnxV- and/or anti-PT-Ab in a collective of patients with different aetiology of thrombophilia is not high. With the exception of one patient presenting isolated anti-PT-IgG-Ab no additional information was gained with the determination of these new parameters.

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