{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:21:49Z","timestamp":1791235309362,"version":"4.1.0"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Anticardiolipin (aCL) and anti-\u03b22 glycoprotein I (a\u03b22GPI) immunoglobulin A (IgA) antiphospholipid antibodies (aPL) have shown to associate with thrombosis and pregnancy morbidity. However, inclusion of IgA aPL in the classification criteria of the antiphospholipid syndrome (APS) has been debated. We investigated the value of aCL and a\u03b22GPI IgA aPL in the detection of thrombosis and pregnancy morbidity in addition to the current aPL panel for APS.<\/jats:p><jats:p>\n          Methods\u2003We included 1,068 patients from eight European medical centers: 259 thrombotic APS patients, 122 obstetric APS patients, 204 non-APS thrombosis patients, 33 non-APS obstetric patients, 60 APS patients with unspecified clinical manifestations, 196 patients with autoimmune diseases, and 194 controls. aCL and a\u03b22GPI IgG\/M\/A were detected with four commercial assays and lupus anticoagulant was determined by the local center.<\/jats:p><jats:p>\n          Results\u2003Positivity for IgA aPL was found in 17 to 26% of the patients with clinical manifestations of APS and in 6 to 13% of the control population. Both aCL and a\u03b22GPI IgA were significantly associated with thrombosis and pregnancy morbidity. Isolated IgA positivity was rare in patients with clinical manifestations of APS (0.3\u20135%) and not associated with thrombosis and\/or pregnancy morbidity. Addition of IgA to the current criterion panel did not increase odds ratios for thrombosis nor pregnancy morbidity.<\/jats:p><jats:p>\n          Conclusion\u2003aCL and a\u03b22GPI IgA are associated with clinical manifestations of APS. However, isolated IgA positivity was rare and not associated with thrombosis or pregnancy morbidity. These data do not support testing for aCL and a\u03b22GPI IgA subsequent to conventional aPL assays in identifying patients with thrombosis or pregnancy morbidity.<\/jats:p>","DOI":"10.1055\/s-0040-1714653","type":"journal-article","created":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T00:04:17Z","timestamp":1595376257000},"page":"1557-1568","source":"Crossref","is-referenced-by-count":26,"title":["Is There an Additional Value in Detecting Anticardiolipin and Anti-\u03b22 glycoprotein I IgA Antibodies in the Antiphospholipid Syndrome?"],"prefix":"10.1055","volume":"120","author":[{"given":"Walid","family":"Chayoua","sequence":"additional","affiliation":[{"name":"Synapse Research Institute, Maastricht, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-mei","family":"Yin","sequence":"additional","affiliation":[{"name":"Synapse Research Institute, Maastricht, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilde","family":"Kelchtermans","sequence":"additional","affiliation":[{"name":"Synapse Research Institute, Maastricht, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary W.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Haemostasis and Thrombosis, Viapath Analytics, Guy's & St. Thomas' Hospitals, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Christophe","family":"Gris","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire de N\u00eemes et Universit\u00e9 de Montpellier, N\u00eemes, France"},{"name":"Ivan Sechenov First Moscow State Medical University, Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Musia\u0142","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Allergy and Immunology, Jagiellonian University Medical College, Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Zuily","sequence":"additional","affiliation":[{"name":"Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, Centre Hospitalier Regional Universitaire de Nancy, Universit\u00e9 de Lorraine, Inserm, DCAC, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"ten Cate","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Thrombosis and Haemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bas","family":"de Laat","sequence":"additional","affiliation":[{"name":"Synapse Research Institute, Maastricht, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrien M. J.","family":"Devreese","sequence":"additional","affiliation":[{"name":"Coagulation Laboratory, Department of Diagnostic Sciences, Ghent University Hospital, Gent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,7,21]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/j.1538-7836.2006.01753.x","article-title":"International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS)","volume":"4","author":"S Miyakis","year":"2006","journal-title":"J Thromb Haemost"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1111\/jth.13976","article-title":"Laboratory criteria for antiphospholipid syndrome: communication from the SSC of the ISTH","volume":"16","author":"K MJ Devreese","year":"2018","journal-title":"J Thromb Haemost"},{"issue":"07","key":"ref3","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1093\/rheumatology\/keu003","article-title":"Contribution of anti-\u03b22glycoprotein I IgA antibodies to the diagnosis of anti-phospholipid syndrome: potential interest of target domains to discriminate thrombotic and non-thrombotic patients","volume":"53","author":"L Despierres","year":"2014","journal-title":"Rheumatology (Oxford)"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1136\/ard.62.6.540","article-title":"Value of IgA anticardiolipin and anti-\u03b22-glycoprotein I antibody testing in patients with pregnancy morbidity","volume":"62","author":"S Carmo-Pereira","year":"2003","journal-title":"Ann Rheum Dis"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1046\/j.1365-2249.1999.01007.x","article-title":"Isotype distribution and clinical relevance of anti-beta2-glycoprotein I (beta2-GPI) antibodies: importance of IgA isotype","volume":"117","author":"G Lakos","year":"1999","journal-title":"Clin Exp Immunol"},{"issue":"09","key":"ref6","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1515\/cclm-2014-0039","article-title":"IgA anticardiolipin and IgA anti-\u03b22 glycoprotein I antibody positivity determined by fluorescence enzyme immunoassay in primary antiphospholipid syndrome","volume":"52","author":"E Mattia","year":"2014","journal-title":"Clin Chem Lab Med"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"64","DOI":"10.3899\/jrheum.100568","article-title":"Association of IgA Anti-\u03b22 glycoprotein I with clinical and laboratory manifestations of systemic lupus erythematosus","volume":"38","author":"T Mehrani","year":"2011","journal-title":"J Rheumatol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/704395","article-title":"Isolated IgA anti- \u03b22 glycoprotein I antibodies in patients with clinical criteria for antiphospholipid syndrome","volume":"2014","author":"R Ruiz-Garc\u00eda","year":"2014","journal-title":"J Immunol Res"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/s10067-005-1156-z","article-title":"Clinical significance of IgA anticardiolipin and anti-\u03b22-GP1 antibodies in patients with systemic lupus erythematosus and primary antiphospholipid syndrome","volume":"25","author":"M Samarkos","year":"2006","journal-title":"Clin Rheumatol"},{"issue":"11","key":"ref10","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1177\/0961203308093460","article-title":"IgA antiphospholipid antibodies are an independent risk factor for thromboses","volume":"17","author":"Y M Shen","year":"2008","journal-title":"Lupus"},{"issue":"08","key":"ref11","doi-asserted-by":"crossref","first-page":"e12280","DOI":"10.1371\/journal.pone.0012280","article-title":"IgA anti-\u03b22-glycoprotein I autoantibodies are associated with an increased risk of thromboembolic events in patients with systemic lupus erythematosus","volume":"5","author":"N J Sweiss","year":"2010","journal-title":"PLoS One"},{"issue":"07","key":"ref12","doi-asserted-by":"crossref","first-page":"e0178889","DOI":"10.1371\/journal.pone.0178889","article-title":"Incidence of thromboembolic events in asymptomatic carriers of IgA anti \u00df2 glycoprotein-I antibodies","volume":"12","author":"C Tortosa","year":"2017","journal-title":"PLoS One"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1177\/0961203310397082","article-title":"\u2018Non-criteria\u2019 aPL tests: report of a task force and preconference workshop at the 13th International Congress on Antiphospholipid Antibodies, Galveston, TX, USA, April 2010","volume":"20","author":"M L Bertolaccini","year":"2011","journal-title":"Lupus"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1055\/s-0038-1649940","article-title":"Induction of thrombosis in a mouse model by IgG, IgM and IgA immunoglobulins from patients with the antiphospholipid syndrome","volume":"74","author":"S S Pierangeli","year":"1995","journal-title":"Thromb Haemost"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.thromres.2017.12.007","article-title":"IgA anti-\u03b22 glycoprotein I antibodies: experience from a large center","volume":"162","author":"A Vlagea","year":"2018","journal-title":"Thromb Res"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1055\/s-0037-1614978","article-title":"IgA anticardiolipin antibodies--relation with other antiphospholipid antibodies and clinical significance","volume":"79","author":"A Selva-O'Callaghan","year":"1998","journal-title":"Thromb Haemost"},{"issue":"12","key":"ref17","first-page":"2637","article-title":"The value of IgA antiphospholipid testing for diagnosis of antiphospholipid (Hughes) syndrome in systemic lupus erythematosus","volume":"28","author":"M L Bertolaccini","year":"2001","journal-title":"J Rheumatol"},{"issue":"12","key":"ref18","doi-asserted-by":"crossref","first-page":"3186","DOI":"10.1002\/art.38131","article-title":"Value of isolated IgA anti-\u03b22 -glycoprotein I positivity in the diagnosis of the antiphospholipid syndrome","volume":"65","author":"V Murthy","year":"2013","journal-title":"Arthritis Rheum"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1093\/ajcp\/98.4.449","article-title":"Clinical significance of immunoglobulin A versus immunoglobulins G and M anti-cardiolipin antibodies in patients with systemic lupus erythematosus. Correlation with thrombosis, thrombocytopenia, and recurrent abortion","volume":"98","author":"L R Lopez","year":"1992","journal-title":"Am J Clin Pathol"},{"issue":"04","key":"ref20","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1055\/s-0032-1311990","article-title":"Internal quality control and external quality assurance in testing for antiphospholipid antibodies: part I--Anticardiolipin and anti-\u03b22-glycoprotein I antibodies","volume":"38","author":"E J Favaloro","year":"2012","journal-title":"Semin Thromb Hemost"},{"issue":"05","key":"ref21","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1055\/s-0039-1679901","article-title":"Detection of anti-cardiolipin and anti-\u03b22glycoprotein I antibodies differs between platforms without influence on association with clinical symptoms","volume":"119","author":"W Chayoua","year":"2019","journal-title":"Thromb Haemost"},{"issue":"07","key":"ref22","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1177\/0961203312439335","article-title":"Standardization of antiphospholipid antibody assays. Where do we stand?","volume":"21","author":"K MJ Devreese","year":"2012","journal-title":"Lupus"},{"issue":"10","key":"ref23","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1111\/j.1538-7836.2009.03555.x","article-title":"Update of the guidelines for lupus anticoagulant detection","volume":"7","author":"V Pengo","year":"2009","journal-title":"J Thromb Haemost"},{"issue":"05","key":"ref24","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1111\/jth.12537","article-title":"Testing for antiphospholipid antibodies with solid phase assays: guidance from the SSC of the ISTH","volume":"12","author":"K MJ Devreese","year":"2014","journal-title":"J Thromb Haemost"},{"issue":"02","key":"ref25","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1080\/003130299105331","article-title":"Clinical utility of anticardiolipin antibody assays: high inter-laboratory variation and limited consensus by participants of external quality assurance programs signals a cautious approach","volume":"31","author":"E J Favaloro","year":"1999","journal-title":"Pathology"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.cca.2016.06.025","article-title":"Clinical significance and correlations between anti-\u03b22 glycoprotein I IgA assays in antiphospholipid syndrome and\/or systemic lupus erythematosus","volume":"460","author":"A E Tebo","year":"2016","journal-title":"Clin Chim Acta"},{"issue":"24","key":"ref27","doi-asserted-by":"crossref","first-page":"12093","DOI":"10.1021\/ac403194t","article-title":"Heterogeneity between diagnostic tests for IgA anti-beta2 glycoprotein I: explaining the controversy in studies of association with vascular pathology","volume":"85","author":"J A Mart\u00ednez-Flores","year":"2013","journal-title":"Anal Chem"},{"issue":"05","key":"ref28","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1111\/ijlh.12543","article-title":"Evaluation of three fully automated immunoassay systems for detection of IgA anti-beta 2-glycoprotein I antibodies","volume":"38","author":"D P\u00e9rez","year":"2016","journal-title":"Int J Lab Hematol"},{"issue":"03","key":"ref29","doi-asserted-by":"crossref","first-page":"282","DOI":"10.3899\/jrheum.120084","article-title":"Utility of antiphosphatidylserine\/prothrombin and IgA antiphospholipid assays in systemic lupus erythematosus","volume":"40","author":"E Akhter","year":"2013","journal-title":"J Rheumatol"},{"issue":"01","key":"ref30","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1177\/096120330000900107","article-title":"Testing for the antiphospholipid syndrome: importance of IgA anti-beta 2-glycoprotein I","volume":"9","author":"T P Greco","year":"2000","journal-title":"Lupus"},{"issue":"03","key":"ref31","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1002\/rth2.12207","article-title":"Influence of anticardiolipin and anti-\u03b22 glycoprotein I antibody cutoff values on antiphospholipid syndrome classification","volume":"3","author":"L Vanoverschelde","year":"2019","journal-title":"Res Pract Thromb Haemost"},{"issue":"03","key":"ref32","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1111\/ijlh.12234","article-title":"Antiphospholipid antibody testing and standardization","volume":"36","author":"K MJ Devreese","year":"2014","journal-title":"Int J Lab Hematol"},{"issue":"03","key":"ref33","doi-asserted-by":"crossref","first-page":"562","DOI":"10.3324\/haematol.2019.221945","article-title":"Seronegative antiphospholipid syndrome: refining the value of \u201cnon-criteria\u201d antibodies for diagnosis and clinical management","volume":"105","author":"P Pignatelli","year":"2020","journal-title":"Haematologica"},{"issue":"04","key":"ref34","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1055\/s-0040-1705115","article-title":"Antiphosphatidylserine\/prothrombin antibodies: an update on their association with clinical manifestations of antiphospholipid 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