FBR Resource Guide


Anti-Phospholipid Antibodies (APA)

Cardiolipin (aCL) - Phosphatidylserine (aPL) IgA, IgG, IgM antibodies by ELISA

Prenatal Screening Laboratory


Specimen Required:
Serum: 2 mL
Room temperature or 4°C
Days Test Set Up:
Run once per week
Analytic Time:

48 hours

Reference Values:

> 98 percentile = Elevated

Reported out in standardized units as IgG Phospholipid Level (GPL), IgM Phospholipid Level (MPL), IgA Phospholipid Level (APL).

CPT Code(s):

86147 x 3 units, 86148 x 3 units

Relevance

The presence of anti-phospholipid antibodies is associated with systemic lupus erythematosus (SLE) or lupus-like disease, arterial or venous thrombosis, thrombocytopenia, recurrent pregnancy loss, postnatal maternal complications, migraine headaches, cerebrovascular accident, transient ischemic attack, or stroke.

Notes

Includes three specific assays for anticardiolipin (aCL) and three antiphosphatidylserine (aPL) antibodies.

Some laboratories have reported that 10-25% of APA positive patients were positive for aPL but negative for aCL. The FBR performs both the aCL and aPL assays as part of the Anti-phospholipid antibody syndrome panel (APS). Testing for both phospholipid antibodies is more clinically relevant than testing for either alone; however, both aCL and aPL may be ordered as individual tests.

Reference(s)

  • Hughes GRV: The antiphospholipid syndrome: 10 years on. Lancet, 342:341, 1993.
  • RDL Newsletter, Vol. 9, No. 2.