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Rheumatology 2002; 41: 550-553
© 2002 British Society for Rheumatology

Original Papers

Value of autoantibodies to ß2-glycoprotein 1 in the diagnosis of antiphospholipid syndrome

M. A. P. Audrain, D. El Kouri1, M. A. Hamidou1, L. Mioche, A. Ibara, M.-L. Langlois and J.-Y. Muller

Laboratoire d'Immunologie and
1 Service de Médecine Interne, Centre Hospitalier Universitaire, 9 quai Moncousu, 44093 Nantes cedex 1, France

Objectives. To define the specificity and positive predictive value of anti-ß2-glycoprotein 1 (anti-ß2GP1) antibodies for the diagnosis of antiphospholipid syndrome (APS).

Methods. We determined the presence of anticardiolipin (aCL) antibodies and anti-ß2-glycoprotein 1 (anti-ß2GP1) immunoglobulin (Ig) G and IgM in 191 consecutive sera from 191 patients and reviewed clinical data separately. aCL IgG and IgM were detected separately using commercial ELISA kits. Anti-ß2GP1 antibodies were detected with an in-house ELISA using ß2GP1.

Results. Seven patients were diagnosed as having APS and 184 as having other diseases. Thirty-six patients were aCL-positive and 12 were anti-ß2GP1-positive, seven of these 12 were APS patients. The specificity for anti-ß2GP1 in our population was 97%, with a positive predictive value (PPV) of 58%. Among the aCL-positive patients, specificity was 90% and PPV 70–87%.

Conclusions. This study shows that anti-ß2GP1 antibodies have a higher specificity and PPV than aCL for APS. The PPV of anti-ß2GP1 was greater in aCL-positive than in all patients. We conclude that screening for anti-ß2GP1 antibodies in aCL-positive patients increases the specificity and the PPV of aCL testing. In addition, we show that there is no need to screen for anti-ß2GP1 antibodies in the absence of aCL antibodies and in the absence of strong clinical suspicion of APS.

KEY WORDS: APS, Anti-ß2GP1 antibodies, aCL antibodies.

Correspondence to: M. A. P. Audrain.


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