Antiphospholipid antibody testing: Which are most useful for diagnosis?

The antiphospholipid syndrome (APS) is a systemic autoimmune disease clinically characterized by recurrent arterial or venous thrombosis or pregnancy complications including recurrent early miscarriages or fetal losses. The presence of antiphospholipid antibodies (aPL) is mandatory to make the laboratory diagnosis of APS. In clinical practice, the "gold standard" tests are those that detect anticardiolipin antibodies (aCL) by ELISA or the lupus anticoagulant (LA) by coagulation tests. Although other specificities for aPL have been described, their clinical utility has still to be established.