Antiphospholipid antibodies

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 03.04.2021

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ACA; antiphospholipid antibodies; Anti-Phospholipid Antibodies; APA; Cardiolipin antibody; Lupus anticoagulant; Phospholipid antibodies; PLA

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Very heterogeneous group of autoantibodies in terms of specificity, isotype and affinity, directed against phospholipids (cardiolipin, phosphaditylcholine, phosphatidylethanolamine, phosphaditylserine, phospaditylinositol).

They can be detected by 3 assay methods:

  • Anti-Cardiolipin-AK (ACA)
  • Lupus anticoagulant test
  • Beta2-glycoprotein

In vitro, the autoantibodies lead to a prolongation of the PTT, but also of the Quick value (lupus anticoagulant!); in vivo, however, accelerated coagulation, a tendency to thrombosis, abortions and thrombopenia occur, especially in the case of high-titer detection; see below. Antiphospholipid antibody syndrome).

Cardiolipin-Ak are also formed in active tuberculosis (see Erythema induratum below).

General information
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The secondary occurrence of antiphospholipid antibodies (PLA) has been associated with various underlying diseases:

Phospholipid antibodies (PLA) are also used in various infectious diseases ( syphilis). Infectious diseases ( syphilis, hepatitis C, HIV, malaria, parvovirus B19) are described.

Drugs: PLA can occur after various drugs. Interferon alfa, amoxicillin, phenytoin, chlorpromazine, rivaroxaban).

Phospholipid antibodies can interact with the platelet membrane due to their binding to phospholipids and thus act as co-factors in different steps of the coagulation cascade. In vivo, this results in a greater activability of the coagulation system with a tendency to thrombosis.

Clinically, migrating thrombophlebitis may also be present. The reaction of phospholipid antibodies with central nervous membrane components can lead to CNS symptoms, e.g. dizziness, partial disturbance of short- and long-term memory, disturbance of fine motor skills up to brain infarctions with hemiplegia and possible cerebral seizures.

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Remember! The term "lupus anticoagulant" is actually a misnomer. Its detection is most strongly associated with an increased risk of thrombosis.

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Last updated on: 03.04.2021