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This study\u2019s objective is to determine whether IgA aCL\/a\u03b22GPI are associated with coagulation and inflammatory responses, as well as a high-risk thrombotic APS (t-APS) profile. A total of 81 patients with t-APS were included. IgA aCL and IgA a\u03b22GPI were measured using chemiluminescence. Coagulation and inflammatory markers (TNF-\u03b1, IL-6, IL-8, IFN-\u03b1, TF, VWF, ADAMTS13) were measured by ELISA, and then, their levels and activity compared between IgA-positive and negative patients. The association of IgA and relevant outcomes (antiphospholipid [aPL] profile, recurrent thrombosis, SLE), was assessed by logistic models adjusted for age and sex. IgA aCL or a\u03b22GPI positivity was observed in 24 patients (29.6%), mostly with both antibodies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923). IgA positivity was not associated with demographics, comorbidities or pregnancy complications, but correlated with triple aPL positivity (48% vs. 13%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004) and higher risk of progression to SLE (17% vs. 0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004). IgA-positive patients showed significantly elevated TNF-\u03b1, IL-8, and TF levels (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.03,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.03 and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.05, respectively). In conclusion, IgA aCL\/a\u03b22GPI positivity is associated with triple aPL positivity, progression to SLE, and altered thromboinflammatory markers, thus highlighting their association with a pronounced thromboinflammatory APS profile. This emphasizes the association of IgA antibodies with a high-risk serological profile and the potential utility of IgA testing in APS.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>Clinical trial registration:<\/jats:italic>\n                      This study is not a clinical trial that requires registration.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11239-026-03316-1","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T06:31:57Z","timestamp":1779085917000},"page":"1644-1653","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of IgA antiphospholipid antibodies with hypercoagulability and inflammation in antiphospholipid syndrome"],"prefix":"10.1007","volume":"59","author":[{"given":"Isabella Constantini Soares","family":"de Andrade","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu\u00edsa Reis Figueiredo","family":"Pinto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silmara Aparecida de Lima","family":"Montalv\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina Pereira","family":"Colella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela Go\u00e9s","family":"Yamaguti-Hayakawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce Maria","family":"Annichino-Bizzacchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich Vin\u00edcius","family":"De Paula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7908-9073","authenticated-orcid":false,"given":"Fernanda Andrade","family":"Orsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"issue":"10","key":"3316_CR1","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1136\/annrheumdis-2019-215213","volume":"78","author":"MG Tektonidou","year":"2019","unstructured":"Tektonidou MG, Andreoli L, Limper M, Amoura Z, Cervera R, Costedoat-Chalumeau N et al (2019) EULAR recommendations for the management of antiphospholipid syndrome in adults. 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The patients\/participants provided their written informed consent to participate in this study. The study includes patient consent statements.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}