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Research Article| Volume 17, ISSUE 3, P395-430, September 1997

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Antiphospholipid Antibodies:

Standardization and Testing
      This paper is only available as a PDF. To read, Please Download here.
      A phenomenon originally scorned as a laboratory nuisance has turned out to be an important cause of thromboembolism, fetal death, and other forms of human disease. Investigations of this inaptly named 'Tupus anticoagulant" has led to the discovery of at least two distinct types of autoimmune antibodies. In spite of recent discoveries regarding the pathophysiology of these antibodies, their clinical significance is still controversial.
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      References

        • Agopian M.S.
        • Boctor F.N.
        • Peter J.B.
        False-positive test result for IgM anticardiolipin antibody due to IgM rheumatoid factor.
        Arthritis Rheum. 1988; 31: 1212-1213
        • Allen J.Y.
        • Tapia-Santiago C.
        • Kutteh W.H.
        Antiphospholipid antibodies in patients with preeclampsia.
        Am J Reprod Immunol. 1996; 36: 81-85
        • Ament L.A.
        Anticardiolipin antibodies.
        A review of the literature. J Nurse Midwifery. 1994; 39: 19-24
        • Amiral J.
        • Adam M.
        • Cluzeau D.
        • et al.
        Different target specificities of phospholipid- dependent antibodies.
        Ann Med Interne (Paris). 1996; 147: 18-21
        • Angelini L.
        • Ravelli A.
        • Caporali R.
        • et al.
        High prevalence of antiphospholipid antibodies in children with idiopathic cerebral ischemia.
        Pediatrics. 1994; 94: 500-503
        • Arnason J.A.
        • Graziano F.M.
        Adrenal insufficiency in the antiphospholipid antibody syndrome.
        Semin Arthritis Rheum. 1995; 25: 109-116
        • Asherson R.A.
        • Piette J.C.
        The catastrophic antiphospholipid syndrome 1996: Acute multi-organ failure associated with antiphospholipid antibodies: A review of 31 patients.
        Lupus. 1996; 5: 414-417
        • Auger W.R.
        • Permpikul P.
        • Moser K.M.
        Lupus anticoagulant, heparin use, and thrombocytopenia in patients with chronic thromboembolic pulmonary hypertension: A preliminary report.
        Am J Med. 1995; 99: 392-396
        • Baker Jr., W.
        • Bick R.L.
        Antiphospholipid antibodies in coronary artery disease: A review.
        Semin Thromb Hemost. 1994; 20: 27-45
        • Balasch J.
        • Font J.
        Antiphospholipid antibodies, low-dose aspirin and pregnancy losses.
        Hum Reprod. 1996; 11: 1140-1141
        • Baleva M.
        • Chauchev A.
        • Dikova C.
        • et al.
        Sneddon's syndrome: Echocardiographic, neurological, and immunologic findings.
        Stroke. 1995; 26: 1303-1304
        • Ballard H.S.
        • Nyamuswa G.
        Life-threatening haemorrhage in a patient with rheumatoid arthritis and a lupus anticoagulant coexisting with acquired autoantibodies against factor VIII.
        Br J Rheumatol. 1993; 32: 515-517
        • Barbour L.A.
        • Pickard J.
        Controversies in thromboembolic disease during pregnancy: A critical review.
        Obstet Gynecol. 1995; 86: 621-633
        • Beaman K.D.
        • Gilman-Sachs A.
        • Cifuentes D.
        • et al.
        Presence of multiple antiphospholipid antibody specificities in a pediatric population.
        Autoimmunity. 1995; 21: 99-106
        • Berard M.
        • Boffa M.C.
        • Karmochkine M.
        • et al.
        Plasma reactivity to hexagonal II phase phosphatidylethanolamine is more frequently associated with lupus anticoagulant than with antiphosphatidylethanolamine antibodies.
        J Lab Clin Med. 1993; 122: 601-605
        • Bernini J.C.
        • Buchanan G.R.
        • Ashcraft J.
        Hypoprothrombinemia and severe hemorrhage associated with a lupus anticoagulant.
        J Pediatr. 1993; 123: 937-939
        • Bick R.L.
        The antiphospholipid-thrombosis syndromes: Fact, fiction, confusion, and controversy.
        Am J Clin Pathol. 1993; 100: 477-480
        • Bick R.L.
        • Ancypa D.
        The antiphospholipid and thrombosis (APL-T) syndromes.
        Clinical and laboratory correlates. Clin Lab Med. 1995; 15: 63-84
        • Bick R.L.
        • Pegram M.
        Syndromes of hypercoagulability and thrombosis: A review.
        Semin Thromb Hemost. 1994; 20: 109-132
        • Biyajima S.
        • Osada T.
        • Daidoji H.
        • et al.
        Pulmonary hypertension and antiphospholipid antibody in a patient with Sjogren's syndrome.
        Intern Med. 1994; 33: 768-772
        • Blanc P.
        • Barki J.
        • Fabre J.M.
        • et al.
        Superior mesenteric vein thrombosis associated with anticardiolipin antibody without autoimmune disease.
        Am J Hematol. 1995; 48: 137
        • Bocciolone L.
        • Meroni P.
        • Parazzini F.
        • et al.
        Antiphospholipid antibodies and risk of intrauterine late fetal death.
        Acta Obstet Gynecol Scand. 1994; 73: 389-392
        • Boffa M.C.
        • Piette J.C.
        Questions-answers about antiphospholipid-protein antibodies and the "antiphospholipid antibody syndrome.".
        Ann Med Interne (Paris). 1996; 147: 54-56
        • Boggild M.D.
        • Sedhev R.V.
        • Fraser D.
        • et al.
        Cerebral venous sinus thrombosis and antiphospholipid antibodies.
        Postgrad Med J. 1995; 71: 487-489
        • Bowie E.J.W.
        • Thompson J.H.
        • Pascuzzi C.A.
        • et al.
        Thrombosis in systemic lupus erythematosus despite circulating anticoagulants.
        J Clin Invest. 1963; 62: 416
        • Branch D.W.
        Thoughts on the mechanism of pregnancy loss associated with the antiphospholipid syndrome.
        Lupus. 1994; 3: 275-280
        • Branch D.W.
        • Silver R.M.
        Criteria for antiphospholipid syndrome: Early pregnancy loss, fetal loss, or recurrent pregnancy loss?.
        Lupus. 1996; 5: 409-413
        • Brandt J.T.
        Antibodies to beta 2-glycoprotein I inhibit phospholipid dependent coagulation reactions.
        Thromb Haemost. 1993; 70: 598-602
        • Brandt J.T.
        • Triplett D.A.
        The effect of phospholipid on the detection of lupus anticoagulants by the dilute Russell viper venom time.
        Arch Pathol Lab Med. 1989; 113: 1376-1378
        • Brandt J.T.
        • Barna L.K.
        • Triplett D.A.
        Laboratory identification of lupus anticoagulants: Results of the Second International Workshop for Identification of Lupus Anticoagulants.
        On behalf of the Subcommittee on Lupus Anticoagulants/Antiphospholipid Antibodies of the ISTH. Thromb Haemost. 1995; 74: 1597-1603
        • Brandt J.T.
        • Triplett D.A.
        • Alving B.
        • et al.
        Criteria for the diagnosis of lupus anticoagulants: An update.
        On behalf of the Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibody of the Scientific and Standardisation Committee of the ISTH. Thromb Haemost. 1995; 74: 1185-1190
        • Brey R.L.
        • Cote S.A.
        • McGlasson D.L.
        • et al.
        Effects of repeated freeze-thaw cycles on anticardiolipin antibody immunoreactivity.
        Am J Clin Pathol. 1994; 102: 586-588
        • Bruyn G.A.
        Controversies in lupus: Nervous system involvement.
        Ann Rheum Dis. 1995; 54: 159-167
        • Burk C.D.
        • Miller L.
        • Handler S.D.
        • et al.
        Preoperative history and coagulation screening in children undergoing tonsillectomy.
        Pediatrics. 1992; 89: 691-695
        • Camps M.T.
        • Cuadrado M.J.
        • Ocon P.
        • et al.
        Association between HLA class II antigens and primary antiphospholipid syndrome from the south of Spain.
        Lupus. 1995; 4: 51-55
        • Cassidy P.G.
        • Triplett D.A.
        • LaDuca F.M.
        Use of the agarose gel method to identify and quantitate factor VIII:C inhibitors.
        Am J Clin Pathol. 1985; 83: 697-706
        • Cervera R.
        • Khamashta M.A.
        • Font J.
        • et al.
        Systemic lupus erythematosus: Clinical and immunologic patterns of disease expression in a cohort of 1000 patients. The European Working Party on Systemic Lupus Erythematosus.
        Medicine (Baltimore). 1993; 72: 113-124
        • Charles L.A.
        • McGlasson D.L.
        • Hawksworth B.A.
        • et al.
        Evaluation of a modified procedure for Staclot LA for the confirmation of lupus anticoagulants.
        Blood Coagul Fibrinolysis. 1994; 5: 601-604
        • Chong B.H.
        • Brighton T.C.
        • Chesterman C.N.
        Antiphospholipid antibodies and platelets.
        Semin Thromb Hemost. 1995; 21: 76-84
        • Cohen H.
        Randomized trial of aspirin versus aspirin and heparin in pregnant women with the antiphospholipid syndrome.
        Ann Med Interne (Paris). 1996; 147: 44
        • Cole A.J.
        Thrombosis in the antiphospholipid-antibody syndrome.
        N Engl J Med. 1995; 333: 666-667
        • Conley C.L.
        • Hartmann R.C.
        A hemorrhagic disorder caused by circulating anticoagulant in patients with disseminated lupus erythematosus.
        J Clin Invest. 1952; 31: 621
        • Cowchock F.S.
        • Reece E.A.
        • Balaban D.
        • et al.
        Repeated fetal losses associated with antiphospholipid antibodies: A collaborative randomized trial comparing prednisone with low-dose heparin treatment.
        Am J Obstet Gynecol. 1992; 166: 1318-1323
        • Cowchock S.
        Prevention of fetal death in the antiphospholipid antibody syndrome.
        Lupus. 1996; 5: 467-472
        • Cowchock S.
        • Fort J.
        • Munoz S.
        • et al.
        False positive ELISA tests for anticardiolipin antibodies in sera from patients with repeated abortion, rheumatologic disorders and primary biliary cirrhosis: Correlation with elevated polyclonal IgM and implications for patients with repeated abortion.
        Clin Exp Immunol. 1988; 73: 289-294
        • Danilenko-Dixon D.R.
        • Van Winter J.T.
        • Homburger H.A.
        Clinical implications of antiphospholipid antibodies in obstetrics.
        Mayo Clin Proc. 1996; 71: 1118-1120
        • De Wolf F.
        • Carreras L.O.
        • Moerman P.
        • et al.
        Decidual vasculopathy and extensive placental infarction in a patient with repeated thromboembolic accidents, recurrent fetal loss, and a lupus anticoagulant.
        Am J Obstet Gynecol. 1982; 142: 829-834
        • Derksen R.H.
        Clinical manifestations and management of the antiphospholipid syndrome.
        Lupus. 1996; 5: 167-169
        • Derksen R.H.
        • Bruinse H.W.
        • de Groot P.G.
        • et al.
        Pregnancy in systemic lupus erythematosus: A prospective study.
        Lupus. 1994; 3: 149-155
        • Dulitzki M.
        • Pauzner R.
        • Langevitz P.
        • et al.
        Low-molecular-weight heparin during pregnancy and delivery: Preliminary experience with 41 pregnancies.
        Obstet Gynecol. 1996; 87: 380-383
        • Eberhard A.
        • Sparling C.
        • Sudbury S.
        • et al.
        Hypoprothrombinemia in childhood systemic lupus erythematosus.
        Semin Arthritis Rheum. 1994; 24: 12-18
        • Egan R.M.
        • Munn R.K.
        Catastrophic antiphospholipid antibody syndrome presenting with multiple thromboses and sites of avascular necrosis.
        J Rheumatol. 1994; 21: 2376-2379
        • Ehrenforth S.
        • Siegert S.
        • Zwinger B.
        • et al.
        A comparison of different test systems in the diagnosis of lupus anticoagulants.
        Lupus. 1994; 3: 352
        • Eng A.M.
        Cutaneous expressions of antiphospholipid syndromes.
        Semin Thromb Hemost. 1994; 20: 71-78
        • England R.J.
        • Woodcock B.
        • Zeiderman M.R.
        Superior mesenteric artery thrombosis in a patient with the antiphospholipid syndrome.
        Eur J Vase Endovasc Surg. 1995; 10: 372-373
        • Erickson Jr., E.
        • Najmey S.S.
        • Keil L.B.
        • et al.
        Reference calibrators for IgG antibodies to beta2-glycoprotein I: Preparation, properties and availability to investigators.
        Clin Chem. 1996; 42: 1116-1117
        • Exner T.
        • Rickard K.A.
        • Kronenberg H.
        A sensitive test demonstrating lupus anticoagulant and its behavioural patterns.
        Br J Haematol. 1978; 40: 143-151
        • Feinstein D.I.
        • Rapaport S.I.
        Acquired inhibitors of blood coagulation.
        Prog Hemostasis Thromb. 1972; 1: 75-95
        • Finazzi G.
        • Brancaccio V.
        • Moia M.
        • et al.
        Natural history and risk factors for thrombosis in 360 patients with antiphospholipid antibodies: A four-year prospective study from the Italian Registry.
        Am J Med. 1996; 100: 530-536
        • Firer M.
        • Sirota P.
        • Schild K.
        • et al.
        Anticardiolipin antibodies are elevated in drug-free, multiply affected families with schizophrenia.
        J Clin Immunol. 1994; 14: 73-78
        • Forastiero R.R.
        • Cerrato G.S.
        • Carreras L.O.
        Evaluation of recently described tests for detection of the lupus anticoagulant.
        Thromb Haemost. 1994; 72: 728-733
        • Forastiero R.R.
        • Martinuzzo M.E.
        • Kordich L.C.
        • et al.
        Reactivity to beta 2 glycoprotein I clearly differentiates anticardiolipin antibodies from antiphospholipid syndrome and syphilis.
        Thromb Haemost. 1996; 75: 717-720
        • Foster W.M.
        • Triplett D.A.
        • Barna L.K.
        Evaluation of seven dilute Russel viper venom (dRWT) kits.
        Lupus. 1994; 3: 351
        • Freeman N.J.
        • Fajardo L.
        • Carvalho A.
        Simultaneous procainamide-induced immune thrombocytopenia and lupus anticoagulant.
        Am J Hematol. 1995; 48: 133-134
        • Furukawa Y.
        • Matsunaga Y.
        • Hayashi K.
        Purification and characterization of a coagulant protein from the venom of Russell's viper.
        Biochim Biophys Acta. 1976; 453: 48-61
        • Galli M.
        • Finazzi G.
        • Barbui T.
        Thrombocytopenia in the antiphospholipid syndrome.
        Br J Haematol. 1996; 93: 1-5
        • Galli M.
        • Finazzi G.
        • Bevers E.M.
        • et al.
        Kaolin clotting time and dilute Russell's viper venom time distinguish between prothrombin-dependent and beta 2-glycoprotein I-dependent antiphospholipid antibodies.
        Blood. 1995; 86: 617-623
        • Galli M.
        • Finazzi G.
        • Barbui T.
        Thrombocytopenia in the antiphospholipid syndrome: Pathophysiology, clinical relevance and treatment.
        Ann Med Interne (Paris). 1996; 147: 24-27
        • Gallo P.
        • Sivieri S.
        • Ferrarini A.M.
        • et al.
        Cerebrovascular and neurological disorders associated with antiphospholipid antibodies in CSF and serum.
        J Neurol Sei. 1994; 122: 97-101
        • Garris G.W.
        • Smith B.D.
        Bilateral adrenal hemorrhage and acute addisonian crisis-a complication of antiphospholipid syndrome.
        J Term Med Assoc. 1996; 89: 120
        • Gastineau D.A.
        • Kazmier F.J.
        • Nichols W.L.
        • et al.
        Lupus anticoagulant: An analysis of the clinical and laboratory features of 219 cases.
        Am J Hematol. 1985; 19: 265-275
        • Gharavi A.E.
        • Wilson W.A.
        The syndrome of thrombosis, thrombocytopenia, and recurrent spontaneous abortions associated with antiphospholipid antibodies: Hughes syndrome.
        Lupus. 1996; 5: 343-344
        • Gharavi A.E.
        • Sammaritano L.R.
        • Bovastro Jr., J.
        • et al.
        Specificities and characteristics of beta 2 glycoprotein I-induced antiphospholipid antibodies.
        J Lab Clin Med. 1995; 125: 775-778
        • Goldberg D.P.
        • Lewis Jr., V.
        • Koenig W.J.
        Antiphospholipid antibody syndrome: A new cause of nonhealing skin ulcers.
        Plast Reconstr Surg. 1995; 95: 837-841
        • Goldsmith G.H.
        • Pierangeli S.S.
        • Branch D.W.
        • et al.
        Inhibition of prothrombin activation by antiphospholipid antibodies and beta 2-glycoprotein 1.
        Br J Haematol. 1994; 87: 548-554
        • Goldstein R.
        • Moulds J.M.
        • Smith C.D.
        • et al.
        MHC studies of the primary antiphospholipid antibody syndrome and of antiphospholipid antibodies in systemic lupus erythematosus.
        J Rheumatol. 1996; 23: 1173-1179
        • Gonzalez G.
        • Gutierrez M.
        • Ortiz M.
        • et al.
        Association of primary antiphospholipid syndrome with primary adrenal insufficiency.
        J Rheumatol. 1996; 23: 1286-1287
        • Grimmer D.
        • Landas S.
        • Kemp J.D.
        IgM antitrophoblast antibodies in a patient with a pregnancy-associated lupuslike disorder, vasculitis, and recurrent intrauterine fetal demise.
        Arch Pathol Lab Med. 1988; 112: 191-193
        • Gupta V.K.
        Migrainous stroke: Are antiphospholipid antibodies pathogenetic, a biological epiphenomenon, or an incidental laboratory aberration?.
        Eur Neurol. 1996; 36: 110-111
        • Guzman L.
        • Thumala A.
        Severe mitral valvular disease in systemic lupus erythematosus.
        Lupus. 1995; 4: 79
        • Hanly J.G.
        • Gladman D.D.
        • Rose T.H.
        • et al.
        Lupus pregnancy.
        A prospective study of placental changes. Arthritis Rheum. 1988; 31: 358-366
        • Harada T.
        • Ohashi T.
        • Fukazawa T.
        • et al.
        Visual function in patients with optic neuritis associated with acute transverse myelopathy in multiple sclerosis.
        Jpn J Ophthalmol. 1995; 39: 290-294
        • Harger J.H.
        • Laifer S.A.
        • Bontempo F.A.
        • et al.
        Low-dose aspirin and prednisone treatment of pregnancy loss caused by lupus anticoagulants.
        J Perinatol. 1995; 15: 463-469
        • Harris E.N.
        The antiphospholipid syndrome.
        Diagnosis, management, and pathogenesis. Clin Rev Allergy Immunol. 1995; 13: 39-48
        • Harris E.N.
        • Pierangeli S.S.
        Antiphospholipid antibodies and the antiphospholipid syndrome.
        Springer Semin Immunopathol. 1994; 16: 223-245
        • Harris E.N.
        • Chan J.K.
        • Asherson R.A.
        • et al.
        Thrombosis, recurrent fetal loss, and thrombocytopenia.
        Predictive value of the anticardiolipin antibody test. Arch Intern Med. 1986; 146: 2153-2156
        • Harris E.N.
        • Gharavi A.E.
        • Boey M.L.
        • et al.
        Anticardiolipin antibodies: Detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus.
        Lancet. 1983; 2: 1211-1214
        • Harvey A.M.
        • Shulman L.E.
        Connective tissue disease and the chronic biologic false positive test for syphilis.
        Med Clin North Am. 1966; 50: 1271-1279
        • Hassell K.L.
        • Kressin D.C.
        • Neumann A.
        • et al.
        Correlation of antiphospholipid antibodies and protein S deficiency with thrombosis in HIV-infected men.
        Blood Coagul Fibrinolysis. 1994; 5: 455-462
        • Humphries J.E.
        • Acker M.N.
        • Pinkston J.E.
        • et al.
        Transient lupus anticoagulant associated with prothrombin deficiency: Unusual cause of bleeding in a 5-year-old girl.
        Am J Pediatr Hematol Oncol. 1994; 16: 372-376
        • Imoto K.
        • Yasumuro Y.
        • Taki M.
        • et al.
        Evaluation of sensitivity and specificity of confirmatory assays for lupus anticoagulant (LA) detection.
        Rinsho Byori. 1996; 44: 797-801
        • Johns A.S.
        • Chamley L.
        • Ockelford P.A.
        • et al.
        Comparison of tests for the lupus anticoagulant and antiphospholipid antibodies in systemic lupus erythematosus.
        Clin Exp Rheumatol. 1994; 12: 523-526
        • Jou I.M.
        • Liu M.F.
        • Chao S.C.
        Widespread cutaneous necrosis associated with antiphospholipid syndrome.
        Clin Rheumatol. 1996; 15: 394-398
        • Kaczor D.A.
        • Bickford N.N.
        • Triplett D.A.
        Evaluation of different mixing study reagents and dilution effect in lupus anticoagulant testing.
        Am J Clin Pathol. 1991; 95: 408-411
        • Kampe C.E.
        Clinical syndromes associated with lupus anticoagulants.
        Semin Thromb Hemost. 1994; 20: 16-26
        • Kandiah D.A.
        • Krilis S.A.
        Beta 2-glycoprotein I.
        Lupus. 1994; 3: 207-212
        • Kennedy M.
        • Jackson J.
        • Khan I.
        • et al.
        Catastrophic anti-phospholipid syndrome in the absence of IgG anti-cardiolipin antibodies.
        Scand J Rheumatol. 1995; 24: 389-391
        • Khamashta M.A.
        • Cuadrado M.J.
        • Mujic F.
        • et al.
        The management of thrombosis in the antiphospholipid-antibody syndrome.
        N Engl J Med. 1995; 332: 993-997
        • Kilpatrick D.C.
        Antiphospholipid antibodies in pregnancy: Prevalence and clinical associations.
        Br J Obstet Gynaecol. 1994; 101: 739-740
        • Knight R.J.
        • Schanzer H.
        • Rand J.H.
        • et al.
        Renal allograft thrombosis associated with the antiphospholipid antibody syndrome.
        Transplantation. 1995; 60: 614-615
        • Ko W.S.
        • Lim P.S.
        • Sung Y.P.
        Renal vein thrombosis as first clinical manifestation of the primary antiphospholipid syndrome.
        Nephrol Dial Transplant. 1995; 10: 1929-1931
        • Kontiainen S.
        • Miettinen A.
        • Seppala I.
        • et al.
        Antiphospholipid antibodies in children.
        Acta Paediatr. 1996; 85: 614-615
        • Kornberg A.
        • Yona R.
        • Luklea S.
        • et al.
        Clinical and laboratory studies on patients with lupus anticoagulant.
        Thromb Res. 1986; 97: 27-32
        • Kurita A.
        • Hasunuma T.
        • Mochio S.
        • et al.
        A young case with multi-infarct dementia associated with lupus anticoagulant.
        Intern Med. 1994; 33: 373-375
        • Laureil A.B.
        • Nilsson I.M.
        Hypergammaglobulinemia, circulating anticoagulant and biologically false positive Wasserman reaction.
        J Lab Clin Med. 1957; 49: 694
        • Lechner K.
        • Pabinger-Fasching I.
        Lupus anticoagulants and thrombosis.
        A study of 25 cases and review of the literature. Haemostasis. 1985; 15: 254-262
        • Lee M.T.
        • Nardi M.A.
        • Hadzi-Nesic Nesic
        • et al.
        Transient hemorrhagic diathesis associated with an inhibitor of prothrombin with lupus anticoagulant in a lV2-year-old girl: Report of a case and review of the literature.
        Am J Hematol. 1996; 51: 307-314
        • Levine S.R.
        • Brey R.L.
        Neurological aspects of antiphospholipid antibody syndrome.
        Lupus. 1996; 5: 347-353
        • Levy R.A.
        Clinical manifestations of the aPL syndrome.
        Lupus. 1996; 5: 393-397
        • Liu H.W.
        • Wong K.L.
        • Lin C.K.
        • et al.
        The reappraisal of dilute tissue thromboplastin inhibition test in the diagnosis of lupus anticoagulant.
        Br J Haematol. 1989; 72: 229-234
        • Lockshin M.D.
        Answers to the antiphospholipid-antibody syndrome?.
        N Engl J Med. 1995; 332: 1025-1027
        • Lockshin M.D.
        • Druzin M.L.
        • Qamar T.
        Prednisone does not prevent recurrent fetal death in women with antiphospholipid antibody.
        Am J Obstet Gynecol. 1989; 160: 439-443
        • Lopez L.R.
        • Santos M.E.
        • Espinoza L.R.
        • et al.
        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. Am J Clin Pathol. 1992; 98: 449-454
        • Lubbe W.F.
        • Liggins G.C.
        Lupus anticoagulant and pregnancy.
        Am J Obstet Gynecol. 1985; 153: 322-327
        • Lynch A.M.
        • Rutledge J.H.
        • Stephens J.K.
        • et al.
        Longitudinal measurement of anticardio- lipin antibodies during normal pregnancy: A prospective study.
        Lupus. 1995; 4: 365-369
        • Manco-Johnson M.J.
        • Nuss R.
        Lupus anticoagulant in children with thrombosis.
        Am J Hematol. 1995; 48: 240-243
        • Manoharan A.
        • Gottlieb P.
        Bleeding in patients with lupus anticoagulant.
        Lancet. 1984; 2: 171
        • Marco P.
        • Lucas J.
        • Alonso A.
        • et al.
        Antiphospholipid antibodies in women with habitual abortions.
        Treatment with prednisone and acetylsalicyclic acid during pregnancy. Sangre (Bare). 1995; 40: 389-392
        • Marzusch K.
        • Dieti J.
        • Klein R.
        • et al.
        Recurrent first trimester spontaneous abortion associated with antiphospholipid antibodies: A pilot study of treatment with intravenous immunoglobulin.
        Acta Obstet Gynecol Scand. 1996; 75: 922-926
        • McIntyre J.A.
        • Taylor C.G.
        • Torry D.S.
        • et al.
        Heparin and pregnancy in women with a history of repeated miscarriages.
        Haemostasis. 1993; 1: 202-211
        • McLean R.M.
        • Greco T.P.
        Anticardiolipin antibodies in the polymyalgia rheumatica- temporal arteritis syndromes.
        Clin Rheumatol. 1995; 14: 191-196
        • McNally T.
        • Mackie I.J.
        • Isenberg D.A.
        • et al.
        Beta 2 glycoprotein-I inhibits factor XII activation on triglyceride rich lipoproteins: The effect of antibodies from plasma of patients with antiphospholipid syndrome.
        Thromb Haemost. 1996; 76: 220-225
        • McNeil H.P.
        • Chesterman C.N.
        • Krilis S.A.
        Anticardiolipin antibodies and lupus anticoagulants comprise separate antibody subgroups with different phospholipid binding characteristics.
        Br J Haematol. 1989; 73: 506-513
        • Messmore H.
        • Fabbrini N.
        • Hoppensteadt D.
        • et al.
        Lupus anticoagulant assays.
        Semin Thromb Hemost. 1994; 20: 79-88
        • Metzdorff M.T.
        • Hanses K.S.
        • Wright G.L.
        • et al.
        Interference with anticoagulation monitoring by procainamide-induced lupus anticoagulant.
        Ann Thorac Surg. 1996; 61: 994-995
        • Meyer O.
        • Nicaise P.
        • Moreau S.
        • et al.
        Antibodies to cardiolipin and beta 2 glycoprotein I in patients with polymyalgia rheumatica and giant cell arteritis.
        Rev Rhum Engl Ed. 1996; 63: 241-247
        • Mihas A.A.
        Gastrointestinal bleeding and intestinal ischemia associated with anticardiolipin antibodies.
        Dig Dis Sei. 1995; 40: 1039-1040
        • Morgan R.J.
        • Feneley R.C.
        Renal vein thrombosis caused by primary antiphospholipid syndrome.
        Br J Urol. 1994; 74: 807-808
        • Nakamura N.
        • Tanaka Y.
        • Hirooka S.
        • et al.
        Administration of human AT-III in a case of lupus anticoagulant positive pregnancy.
        Rinsho Ketsueki. 1993; 34: 649-655
        • Naidi L.
        • Locati F.
        • Marchesi L.
        • et al.
        Cutaneous manifestations associated with antiphospholipid antibodies in patients with suspected primary antiphospholipid syndrome: A case-control study.
        Ann Rheum Dis. 1993; 52: 219-222
        • Nanulescu M.
        • Trif I.
        • Cucuianu M.
        • et al.
        Lupus anticoagulant and transient severe bleeding tendency in a girl aged nine years.
        Medicina Interna. 1988; 26: 115-119
        • Nickele G.A.
        • Foster P.A.
        • Kenny D.
        Primary antiphospholipid syndrome and mitral valve thrombosis.
        Am Heart J. 1994; 128: 1245-1247
        • Nilsson I.M.
        • Astedt B.
        • Hedner U.
        • et al.
        Intrauterine death and circulating anticoagulant, //antithromboplastin..
        Acta Med Scand. 1975; 197: 153
        • Ordi J.
        • Vilardel M.
        • Oristrell J.
        • et al.
        Bleeding in patients with lupus anticoagulant.
        Lancet. 1984; 2: 868-869
        • Ornstein M.H.
        • Rand J.H.
        An association between refractory HELLP syndrome and antiphospholipid antibodies during pregnancy; a report of 2 cases.
        J Rheumatol. 1994; 21: 1360-1364
        • Oshiro B.T.
        • Silver R.M.
        • Scott J.R.
        • et al.
        Antiphospholipid antibodies and fetal death.
        Obstet Gynecol. 1996; 87: 489-493
        • Pangborn M.C.
        A new serologically active phospholipid from beef heart.
        Proc Soc Exp Biol Med. 1941; 48: 484-486
        • Papadopoulos K.I.
        • Jonsson A.
        • Berntorp E.
        • et al.
        Primary antiphospholipid syndrome associated with postoperative primary adrenal failure.
        J Intern Med. 1995; 238: 175-178
        • Peddi V.R.
        • Kant K.S.
        Catastrophic secondary antiphospholipid syndrome with concomitant antithrombin III deficiency.
        J Am Soc Nephrol. 1995; 5: 1882-1887
        • Petri M.
        Clinical features of systemic lupus erythematosus.
        Curr Opin Rheumatol. 1995; 7: 395-401
        • Petri M.
        • Rheinschmidt M.
        • Whiting-O'Keefe Q.
        • et al.
        The frequency of lupus anticoagulant in systemic lupus erythematosus.
        A study of sixty consecutive patients by activated partial thromboplastin time, Russell viper venom time, and anticardiolipin antibody level. Ann Intern Med. 1987; 106: 524-531
        • Piette J.C.
        • Frances C.
        "Catastrophic antiphospholipid syndrome crisis.".
        Clin Exp Rheumatol. 1994; 12: 346
        • Piette J.C.
        • Karmochkine M.
        • Papo T.
        • et al.
        Treatment of the antiphospholipid syndrome.
        Clin Rev Allergy Immunol. 1995; 13: 73-89
        • Rao L.V.M.
        • Hoang A.D.
        • Rapaport S.I.
        Mechanism and effects of the binding of lupus anticoagulant IgG and prothrombin to surface phospholipid.
        Blood. 1996; 88: 4173-4182
        • Rauch J.
        • Janoff A.S.
        Phospholipid in the hexagonal phase II is immunogenic: Evidence for immunorecognition of nonbilayer lipid phases in vivo.
        Proc Natl Acad Sei USA. 1990; 87: 4112-4114
        • Rauch J.
        • Tannenbaum M.
        • Janoff A.S.
        Distinguishing plasma lupus anticoagulants from anti-factor antibodies using hexagonal (II) phase phospholipids.
        Thromb Haemost. 1989; 62: 892-896
        • Rauch J.
        • Tannenbaum M.
        • Tannenbaum H.
        • et al.
        Human hybridoma lupus anticoagulants distinguish between lamellar and hexagonal phase lipid systems.
        J Biol Chem. 1986; 261: 9672-9677
        • Reber G.
        • Arvieux J.
        • Comby E.
        • et al.
        Multicenter evaluation of nine commercial kits for the quantitation of anticardiolipin antibodies.
        The Working Group on Methodologies in Haemostasis from the GEHT (Groupe d'Etudes sur FHemostase et la Thrombose). Thromb Haemost. 1995; 73: 444-452
        • Reyes H.
        • Dearing L.
        • Bick R.L.
        • et al.
        Laboratory diagnosis of antiphospholipid syndromes.
        Clin Lab Med. 1995; 15: 85-108
        • Reyes H.
        • Dearing L.
        • Shoenfeld Y.
        • et al.
        Antiphospholipid antibodies: A critique of their heterogeneity and hegemony.
        Semin Thromb Hemost. 1994; 20: 89-100
        • Roisin J.-P.
        • Contant G.
        • Martinoli J.-L.
        Use of hexagonal phosphatidylethanolamine and of an APTT reagent sensitive to LA.
        Thromb Haemost. 1991; 65: 2023
        • Rosner E.
        • Pauzner R.
        • Lusky A.
        • et al.
        Detection and quantitative evaluation of lupus circulating anticoagulant activity.
        Thromb Haemost. 1987; 57: 144-147
        • Rosove M.H.
        • Brewer P.M.
        • Runge A.
        • et al.
        Simultaneous lupus anticoagulant and anticardiolipin assays and clinical detection of antiphospholipids.
        Am J Hematol. 1989; 32: 148-149
        • Rosove M.H.
        • Vollset S.E.
        • Runge A.
        Sensitivities of lupus anticoagulant assays.
        Am J Hematol. 1989; 32: 237-238
        • Roubey R.A.
        Autoantibodies to phospholipid-binding plasma proteins: A new view of lupus anticoagulants and other "antiphospholipid" autoantibodies.
        Blood. 1994; 84: 2854-2867
        • Roubey R.A.
        Antigenic specificities of antiphospholipid autoantibodies: Implications for clinical laboratory testing and diagnosis of the antiphospholipid syndrome.
        Lupus. 1996; 5: 425-430
        • Roubey R.A.
        The antiphospholipid antibody syndrome: New pieces to the puzzle.
        Bull Rheum Dis. 1994; 43: 6-8
        • Roubey R.A.
        Immunology of the antiphospholipid antibody syndrome.
        Arthritis Rheum. 1996; 39: 1444-1454
        • Roubey R.A.
        • Eisenberg R.A.
        • Harper M.F.
        • et al.
        "Anticardiolipin" autoantibodies recognize beta 2-glycoprotein I in the absence of phospholipid.
        Importance of Ag density and bivalent binding. J Immunol. 1995; 154: 954-960
        • Ruffatti A.
        • De-Silvestro G.
        • Ghirardello A.
        • et al.
        A catastrophic antiphospholipid syndrome: The importance of high levels of warfarin anticoagulation.
        J Intern Med. 1994; 235: 81-83
        • Ryan J.
        • Lasorda D.
        • Spero J.
        • et al.
        Thrombolysis of right atrial thrombus with pulmonary embolism in anticardiolipin antibody syndrome.
        Am Heart J. 1995; 130: 905-907
        • Sachse C.
        • Luthke K.
        • Hartung K.
        • et al.
        Significance of antibodies to cardiolipin in unselected patients with systemic lupus erythematosus: Clinical and laboratory associations.
        The SLE Study Group. Rheumatol Int. 1995; 15: 23-29
        • Salem H.H.
        Antiphospholipid antibodies and thrombosis: Assessment of the potential risk for thrombosis.
        Lupus. 1996; 5: 163-166
        • Sandoval J.
        • Amigo M.C.
        • Barragan R.
        • et al.
        Primary antiphospholipid syndrome presenting as chronic thromboembolic pulmonary hypertension.
        Treatment with thrombo- endarterectomy. J Rheumatol. 1996; 23: 772-775
        • Sant S.M.
        • Barry M.A.
        Thrombosis of the inferior vena cava in the anti-phospholipid syndrome.
        Clin Exp Rheumatol. 1994; 12: 423-424
        • Schieider M.A.
        • Nachman R.L.
        • Jaffe E.A.
        • et al.
        A clinical study of the lupus anticoagulant.
        Blood. 1976; 48: 499-509
        • Schlesinger I.H.
        • Färber G.A.
        Cutaneous ulceration resembling pyoderma gangrenosum in the primary antiphospholipid syndrome: A report of two additional cases and review of the literature.
        J La State Med Soc. 1995; 147: 357-361
        • Schved J.F.
        • Dupuy-Fons C.
        • Biron C.
        • et al.
        A prospective epidemiological study on the occurrence of antiphospholipid antibody: The Montpellier Antiphospholipid (MAP) Study.
        Haemostasis. 1994; 24: 175-182
        • Sebastiani G.D.
        • Galeazzi M.
        • Morozzi G.
        • et al.
        The immunogenetics of the antiphospholipid syndrome, anticardiolipin antibodies, and lupus anticoagulant.
        Semin Arthritis Rheum. 1996; 25: 414-420
        • Selva A.
        • Ordi J.
        • Roca M.
        • et al.
        Pyoderma-gangraenosum-like ulcers associated with lupus anticoagulant.
        Dermatology. 1994; 189: 182-184
        • Shapiro G.A.
        Antiphospholipid syndrome in obstetrics and gynecology.
        Semin Thromb Hemost. 1994; 20: 64-70
        • Shapiro S.S.
        The lupus anticoagulant/antiphospholipid syndrome.
        Annu Rev Med. 1996; 47: 533-553
        • Shi W.
        • Chong B.H.
        • Chesterman C.N.
        Beta 2-glycoprotein I is a requirement for anticardiolipin antibodies binding to activated platelets: Differences with lupus anticoagulants.
        Blood. 1993; 81: 1255-1262
        • Shi W.
        • Krilis S.A.
        • Chong B.H.
        • et al.
        Prevalence of lupus anticoagulant and anticardiolipin antibodies in a healthy population.
        Aust NZ J Med. 1990; 20: 231-236
        • Shirai T.
        • Sato A.
        • Chida K.
        • et al.
        A case of recurrent pulmonary thromboembolism presenting with positive antiphospholipid antibodies.
        Nippon Kyobu Shikkan Gak- kai Zasshi. 1994; 32: 700-703
        • Silver R.K.
        • MacGregor S.N.
        • Sholl J.S.
        • et al.
        Comparative trial of prednisone plus aspirin versus aspirin alone in the treatment of anticardiolipin antibody-positive obstetric patients.
        Am J Obstet Gynecol. 1993; 169: 1411-1417
        • Sletnes K.E.
        • Gravem K.
        • Wisloff F.
        Preparation of plasma for the detection of lupus anticoagulants and antiphospholipid antibodies.
        Thromb Res. 1992; 66: 43-53
        • Sohngen D.
        • Wehmeier A.
        • Specker C.
        • et al.
        Antiphospholipid antibodies in systemic lupus erythematosus and Sneddon's syndrome.
        Semin Thromb Hemost. 1994; 20: 55-63
        • Spinnato J.A.
        • Clark A.L.
        • Pierangeli S.S.
        • et al.
        Intravenous immunoglobulin therapy for the antiphospholipid syndrome in pregnancy.
        Am J Obstet Gynecol. 1995; 172: 690-694
        • Stevenson K.J.
        • Seddon J.M.
        The role of lipids in the detection of lupus anticoagulant by the dilute Russell Viper venom test: Are platelets or reagents containing hexagonal HII phases necessary?.
        Br J Haematol. 1994; 86: 583-589
        • Stocker K.
        • Hauer H.
        • Muller C.
        • et al.
        Isolation and characterization of textarin, a prothrombin activator from eastern brown snake venom.
        Toxicon. 1994; 32: 1227-1236
        • Thiagarajan P.
        • Pengo V.
        • Shapiro S.S.
        The use of the dilute Russell viper venom time for the diagnosis of lupus anticoagulants.
        Blood. 1986; 68: 869-874
        • Tincani A.
        • Spatola L.
        • Cattaneo R.
        • et al.
        Antiphospholipid ELISA: The state of the art.
        Lupus. 1996; 5: 477-479
        • Tishler M.
        • Papo J.
        • Yaron M.
        Skin ulcer as the presenting symptom of primary antiphospholipid syndrome-resolution with anticoagulant therapy.
        Clin Rheumatol. 1995; 14: 112-114
        • Tohgi H.
        • Takahashi H.
        • Kashi waya M.
        • et al.
        The anticardiolipin antibody in elderly stroke patients: Its effects on stroke types, recurrence, and the coagulation-fibrinolysis system.
        Acta Neurol Scand. 1994; 90: 86-90
        • Tomer Y.
        • Viegas O.A.
        • Swissa M.
        • et al.
        Levels of lupus autoantibodies in pregnant SLE patients: Correlations with disease activity and pregnancy outcome.
        Clin Exp Rheumatol. 1996; 14: 275-280
        • Triplett D.A.
        Antiphospholipid-protein antibodies: Laboratory detection and clinical relevance.
        Thromb Res. 1995; 78: 1-31
        • Triplett D.A.
        • Brandt J.
        Laboratory identification of the lupus anticoagulant.
        Br J Haematol. 1989; 73: 139-142
        • Triplett D.A.
        Lupus anticoagulants/antiphospholipid-protein antibodies: The great imposters.
        Lupus. 1996; 5: 431-435
        • Triplett D.A.
        • Bama L.K.
        • Unger G.A.
        A hexagonal (II) phase phospholipid neutralization assay for lupus anticoagulant identification.
        Thromb Haemost. 1993; 70: 787-793
        • Triplett D.A.
        • Brandt J.T.
        • Kaczor D.
        • et al.
        Laboratory diagnosis of lupus inhibitors: A comparison of the tissue thromboplastin inhibition procedure with a new platelet neutralization procedure.
        Am J Clin Pathol. 1983; 79: 678-682
        • Triplett D.A.
        • Stocker K.F.
        • Unger G.A.
        • et al.
        The textarin/ecarin ratio: A confirmatory test for lupus anticoagulants.
        Thromb Haemost. 1993; 70: 925-931
        • Van Horn G.
        • Arnett F.C.
        • Dimachkie M.M.
        Reversible dementia and chorea in a young woman with the lupus anticoagulant.
        Neurology. 1996; 46: 1599-1603
        • Vargas-Alarcon G.
        • Granados J.
        • Bekker C.
        • et al.
        Association of HLA-DR5 (possibly DRB1*1201) with the primary antiphospholipid syndrome in Mexican patients.
        Arthritis Rheum. 1995; 38: 1340-1341
        • Vermylen J.
        • Amout J.
        Is the antiphospholipid syndrome caused by antibodies directed against physiologically relevant phospholipid-protein complexes?.
        J Lab Clin Med. 1992; 120: 10
        • Vila P.
        • Hernandez M.C.
        • Lopez-Fernandez M.F.
        • et al.
        Prevalence, follow-up and clinical significance of the anticardiolipin antibodies in normal subjects.
        Thromb Haemost. 1994; 72: 209-213
        • Vivaldi P.
        • Andreotti C.
        • Mazzon C.
        • et al.
        A "primitive" catastrophic antiphospholipid syndrome.
        Haematologica. 1994; 79: 173-176
        • Voisin L.
        • Derumeaux G.
        • Borg J.Y.
        • et al.
        Catastrophic antiphospholipid syndrome with fatal acute course in rheumatoid arthritis.
        J Rheumatol. 1995; 22: 1586-1588
        • von Scheven E.
        • Athreya B.H.
        • Rose C.D.
        • et al.
        Clinical characteristics of antiphospholipid antibody syndrome in children.
        J Pediatr. 1996; 129: 339-345
        • Wasserman A.
        Uber die entwicklung und den gegen wartigen stand der serodiagnos- tek gegenüber syphilis.
        Berl Klin Wochenschr. 1907; 44: 1599
        • Yasuda M.
        • Takakuwa K.
        • Tokunaga A.
        • et al.
        Prospective studies of the association between anticardiolipin antibody and outcome of pregnancy.
        Obstet Gynecol. 1995; 86: 555-559
        • Yetman D.L.
        • Kutteh W.H.
        Antiphospholipid antibody panels and recurrent pregnancy loss: Prevalence of anticardiolipin antibodies compared with other antiphospholipid antibodies.
        Fertil Steril. 1996; 66: 540-546
        • Yutani C.
        • Imakita M.
        • Ishibashi-Ueda Ueda
        • et al.
        Pulmonary thromboembolic hypertension in systemic lupus erythematosus with lupus anticoagulant: Histopathological analysis of localization and distribution of thromboemboli in pulmonary vasculature [see comments].
        Intern Med. 1995; 34: 1030-1034
        • Zarrabi M.J.
        • Zucker S.
        • Miller F.
        • et al.
        Immunologic and coagulation disorders in chlorpromazine-treated patients.
        Ann Intern Med. 1979; 91: 194