Antiphospholipid antibodies — lupus anticoagulant, anticardiolipin and anti-β2-glycoprotein I — are present in a substantial minority of people with SLE and mark a much higher risk of arterial and venous thrombosis, including stroke, and of pregnancy loss.
Testing at diagnosis, and repeating positive results after 12 weeks to confirm persistence, identifies the patients in whom thrombosis prevention and pregnancy planning must be handled differently.
- Order all three antiphospholipid tests at diagnosis of SLE
- Repeat positive results at least 12 weeks later
- Note that lupus anticoagulant testing is unreliable on anticoagulants
- Review thrombosis prevention and contraception choices in persistently positive patients
Why it matters
Antiphospholipid positivity is one of the most important modifiable pieces of stroke and pregnancy risk in lupus.
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