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-   -   Не следует искать АФА после однократно замершей беременности на сроке до 12 недель (https://forums.rusmedserv.com/showthread.php?t=258615)

Dr.Vad 14.12.2012 23:35

Не следует искать АФА после однократно замершей беременности на сроке до 12 недель
Выдержки из недавней обучающей статьи:

...which patients should be selected for laboratory testing?

...pregnant women without histories of complications [or one time miscarriage] should not be screened for these tests to identify high-risk pregnancies. These assays carry significant rates of false positivity... In one group of young women who served as healthy controls for a study, 18.2% had elevated levels of aCL Abs and 12.8% tested positive for LA. Obtaining a positive aPL test result in an otherwise disease-free individual has the major downside of opening the door to possibility of unnecessary anticoagulant prophylaxis with the potential of hemorrhagic complications...

The Antiphospholipid Antibodies Subcommittee of the International Society of Thrombosis and Hemostasis has recommended that: young patients with recurrent spontaneous early pregnancy loss and provoked venous thromboembolism and asymptomatic patients who are incidentally found to have a prolonged aPTT should be included in a moderate-appropriateness group,... the high-appropriateness group category: late pregnancy loss, and any thrombosis or pregnancy morbidity in patients with autoimmune diseases (eg, SLE, rheumatoid arthritis, autoimmune thrombocytopenia, or autoimmune hemolytic anemia).

How specific are positive aPL tests for APS?

Testing positive for aCL Abs does not necessarily mean that a patient has APS. The positive test may be triggered by a preceding infection, the most common of which are syphilis and Lyme disease. In addition, aCL positivity can be triggered by EBV, CMV, HIV, and hepatitis C virus.

Always rule out infection as the potential cause of positive aCL immunoassays!
Dos and don'ts in diagnosing antiphospholipid syndrome
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