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- W4321000986 abstract "APLs exhibit a broad diversity of immunologic specificities. Clinically significant (autoimmune or thrombosis inducing) APL detected by ELISA bind a complex of PL and $bT2-GPl. APL detected using clotting tests may bind complexes of PL with $bT2-GPl, prothrombin, or even heparins. These autoantibodies have profound effects on intrinsic and extrinsic clotting pathways and on endothelial cell and platelet biology. The broad heterogeneity of APL is reflected in the wide variety of clinical manifestations associated with them. Patients in whom the presence of APL is suspected should always be tested using both ELISA and clotting tests. Because these tests detect the entire family of APL, the significance of positive results is dependent on the clinical setting. The pathophysiologic effects of APL are varied, reflecting the broad spectrum of binding specificities of these antibodies. APL could cause thrombosis via platelet activation, endothelial cell surface binding, interference with the activities of activated protein C, inhibition of fibrinolysis, or via immunologic mechanisms, such as ADCC or complement-mediated lysis. Pregnant women at risk for thrombosis during pregnancy should usually be placed on heparin at doses adequate for prophylaxis. Treatment with corticosteroids is generally directed to associated autoimmune disorders, whereas IVIG is reserved for pregnancies at very high risk. The next generation of diagnostic tests may allow us to diagnose autoantibodies directed to specific phospholipid protein complexes, to predict clinical consequences, and to prescribe specific therapies based more clearly on pathophysiologic mechanisms." @default.
- W4321000986 created "2023-02-17" @default.
- W4321000986 creator A5039837204 @default.
- W4321000986 creator A5065949702 @default.
- W4321000986 date "1994-11-01" @default.
- W4321000986 modified "2023-09-23" @default.
- W4321000986 title "ANTIPHOSPHOLIPID ANTIBODIES" @default.
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