{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T05:55:41Z","timestamp":1793858141432,"version":"4.6.1"},"reference-count":27,"publisher":"Walter de Gruyter GmbH","issue":"5","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_cclm-2025-1565_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Antiphosphatidylserine\/prothrombin (aPS\/PT) antibodies are promising non-criteria aPLs associated with antiphospholipid syndrome (APS) manifestations. Their influence on long-term outcomes and damage remains uncertain. To assess aPS\/PT antibodies association with accrual damage and severe APS disease phenotypes, focusing on their potential for risk stratification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-1565_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-centre cohort study involved 163 patients who fulfilled the 2023 ACR\/EULAR APS criteria. IgG\/IgM aPS\/PT, aCL, and anti-\u03b22GPI antibodies were measured by commercial ELISA. Lupus anticoagulant (LA) was detected in accordance with the ISTH-SSC recommendation. Clinical data covered macrovascular, microvascular, obstetric, and hematologic manifestations. Damage was assessed using DIAPS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-1565_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>aPS\/PT IgG and IgM were positive in 46.0\u202f% and 65.6\u202f%, respectively. aPS\/PT IgG positivity was linked to microvascular involvement (58.7\u202f% vs. 34.1\u202f%, p=0.002), obstetric APS (57.4\u202f% vs. 24.6\u202f%, p&lt;0.0001), valvular disease (17.3\u202f% vs. 4.6\u202f%, p=0.008), and thrombocytopenia (37.3\u202f% vs. 12.5\u202f%, p&lt;0.0001). aPS\/PT IgM positivity was also associated with microvascular APS (p=0.006), obstetric morbidity (p=0.02), and thrombocytopenia (p=0.01). In multivariable analysis, quadruple aPL positivity (LA\u00a0+\u00a0aCL\u00a0+\u00a0anti-\u03b22GPI\u00a0+\u00a0aPS\/PT) was independently linked to damage (OR 4.3, 95\u202f% CI 1.3\u201314.5; p=0.02), with no other factors remaining significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-1565_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both IgG and IgM aPS\/PT antibodies are associated with severe APS features, including microvascular and obstetric issues, as well as overall organ damage. Adding aPS\/PT to standard aPL tests finds a subgroup of quadruple-positive APS patients at higher risk of damage. These results could help guide personalized APS management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/cclm-2025-1565","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T05:56:30Z","timestamp":1770098190000},"page":"1133-1141","source":"Crossref","is-referenced-by-count":3,"title":["Antiphosphatidylserine\/prothrombin antibodies define a high-risk antiphospholipid syndrome profile associated with organ damage"],"prefix":"10.1515","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7741-6432","authenticated-orcid":false,"given":"Ariela","family":"Hoxha","sequence":"first","affiliation":[{"name":"Department of Medicine - DIMED , University of Padua , Padova , Italy"},{"name":"Internal Medicine Unit, Thrombosis and Bleeding Disorder Center , Padua University Hospital , Padova , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Gobbo","sequence":"additional","affiliation":[{"name":"Department of Medicine - DIMED , University of Padua , Padova , Italy"},{"name":"Internal Medicine Unit, Thrombosis and Bleeding Disorder Center , Padua University Hospital , Padova , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Gavasso","sequence":"additional","affiliation":[{"name":"Department of Medicine - DIMED , University of Padua , Padova , Italy"},{"name":"Internal Medicine Unit, Thrombosis and Bleeding Disorder Center , Padua University Hospital , Padova , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Montagna","sequence":"additional","affiliation":[{"name":"Department of Medicine - DIMED , University of Padua , Padova , Italy"},{"name":"Internal Medicine Unit, Thrombosis and Bleeding Disorder Center , Padua University Hospital , Padova , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Sartorello","sequence":"additional","affiliation":[{"name":"Department of Medicine - DIMED , University of Padua , Padova , Italy"},{"name":"Internal Medicine Unit, Thrombosis and Bleeding Disorder Center , Padua University Hospital , Padova , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Tonello","sequence":"additional","affiliation":[{"name":"Department of Medicine - DIMED , University of Padua , Padova , Italy"},{"name":"Rheumatology Unit , Padua University Hospital , Padova , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Zerbinati","sequence":"additional","affiliation":[{"name":"Department of Medicine - DIMED , University of Padua , Padova , Italy"},{"name":"Internal Medicine Unit, Thrombosis and Bleeding Disorder Center , Padua University Hospital , Padova , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Ramonda","sequence":"additional","affiliation":[{"name":"Department of Medicine - DIMED , University of Padua , Padova , Italy"},{"name":"Rheumatology Unit , Padua University Hospital , Padova , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Simioni","sequence":"additional","affiliation":[{"name":"Department of Medicine - DIMED , University of Padua , Padova , Italy"},{"name":"Internal Medicine Unit, Thrombosis and Bleeding Disorder Center , Padua University Hospital , Padova , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"2026033013262436969_j_cclm-2025-1565_ref_001","doi-asserted-by":"crossref","unstructured":"Knight, JS, Branch, DW, Ortel, TL. 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