Role of anticardiolipin antibodies in bad obstetric history detected by ELISA test in a tertiary care centre

Year 2017, , 43 - 47, 30.06.2017

Therese Mary Dhason

https://doi.org/10.5455/jicm.24.259659

Abstract

Background: Antiphospholipid
syndrome (APS) is one of the causes of recurrent abortions and intrauterine
death among pregnant women. This study was undertaken to find out the
association between bad obstetric history (BOH) and anticardiolipin (aCL)
antibody.

Material and Methods: Blood samples were collected from women with BOH referred
(recurrent abortion, intrauterine death, PIH) to a Tertiary Care Center in
Chennai, Tamil Nadu. Blood samples from 100 pregnant women with BOH and 110
healthy pregnant women were collected and tested for the presence of  aCL antibody by ELISA Method.

Results: Among
the 100 patients tested 21 (21%) were aCL 
positive; IgG was positive in 16 (76.19%) patients and IgM was positive
in 5(23.80%) patients. Anticordiolipin antibody (aCL) positivity in BOH was
statistically significant (p .0048) when compared to healthy pregnant women.
There was a positive correlation (p 0.005) between IgG and BOH. The antibody
titer was high in 12 (57.14%) and moderate in 6 (28.57%). Among the controls 8(7.2%)
were aCL  positive.

Conclusion: Screening
of patients with BOH for aCL by ELISA will reduce foetal morbidity and
mortality as there is a significant association between high, moderate titers
of aCL, (IgG) and BOH.

Keywords

Antiphospholipid syndrome, Anticordiolipin Elisa, Bad Obstetric History

References

• 1. Miyakis S, Lockshin MD, Atsumi T, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4:295-306.
• 2. Rheumatology Marc C. Hochberg, Alan J. Silman, Josef S.Smolen, Michael E.Weinblatt, Michael H.Weisman VI edition, Elsevier, volume 2, chapter 139:1144.
• 3. Wilson W A, Gharavi AE, Koike T., International consensus statement on preliminary classification for definite Antiphospholipid syndrome. Arthritis Rheum 1999;42:1309-1311.
• 4. Harris EN. Special report. The second International Anti-cardiolipin standardization workshop 1 the kingston Anti-phospholipid Antibody study (KAPS) group. Am J Clin Pathol 1990; 94(4): 476-484.
• 5. Pierangeli SS, Harris EN. Clinical laboratory testing for the antiphospholipid syndrome. Clin Chim Acta 2005;357:17-33.
• 6. Kelley’s Textbook of Rheumatology, Eleviers Saunders, Vol II, 9th edition, 2013: P:1332.
• 7. Harris EN, Gharavi AE, Patel S, Hughes GRV. Evaluation of the anticardiolipin antibody test: report of an International workshop held 4 April 1986. Clin Exp Immunol 1987;68:215-222.
• 8. Ginsburg KS, Liang MH, Newcomer I, Anticardiolipin antibodies and the risk for ischemic stroke and venous thrombosis. Ann intem Med 1992;117:997-1002.
• 9. Levine JS, Branch DW, Rauch J. The antiphospholipid syndrome. N Engl J Med 2002;346:752-763.
• 10. Brey RL, Abbott RD, Cub JD, et β2-glycoprotein-dependent anticordiolipin antibodies and risk of ischemic stroke and myocardial infarction; the Honolulu Heart Programme Stroke, 2001;32;1701-1706.
• 11. Rand J H. Antiphospholipid antibody mediated disruption of Annexin V antithrombotic shield: a thrombogenic mechanism for the Antiphospholipid syndrome. J Autoimmune 2000:15:107-111.
• 12. Di Simone N, Raschi E, TestoniC,. pathogenic role of anti-beta 2-glycoprotein I antibodies in antiphospholipid associated fetal loss: characterization of beta 2-glycoprotein I binding to trophoblast cells and functional effects of anti-beta 2-glycoprotein I antibodies in vitro. Ann Rheum Dis 2005;64: 462-467.
• 13. Danza A, Ruiz-Irastorza G, Khamashta M. Antiphospholipid syndrome in obstetrics. Best Pract Res Clin Obstet Gynaecol 2012;26:65-76.
• 14. Ruffatti A, Calligaro A, Hoxha A, et al. Laboratory and clinical features of pregnant women with antiphospholipid syndrome and neonatal outcome. Arthritis Care Res 2010;62:302-307.
• 15. Nesher G, Rosenman D, Abraham AS. Valvulardystfunction in Antiphospholipid syndrome; prevalence, clinical features and treatment, Semin Arthritis, Rhem 1997:27:27-35.
• 16. Levine SR, Salowich-Palm L, Sawaya KL, IgG anticardiolipin antibody titer > 40 GPL and the risk of subsequent thrombo-occlusive events and death. A prospective cohort study. Stroke 1997;28:1660-1665.
• 17. Rheumatology Marc C. Hochberg, Alan J.Silman, Josef S.Smolen, Michael E.Weinblatt, Michael H.Weisman VI edition, Elsevier, volume 2, chapter 139:1146.
• 18. Stephenson MD: Frequency of factors associated with habitual abortion in 197 couples. Fertil Steril 1996;66:24-29.
• 19. Kuttch NH. Antiphospholipid antibody-associated recurrent pregnancy loss: Treatment with heparin and low dose aspirin is superior to low dose aspirin alone. Am J Obstet Gynecol 1996;174:1584-1589.