Abstract：
BACKGROUND:The antiphospholipid syndrome (APS) is an important cause of acquired thromboembolic complications and pregnancy morbidity. Its diagnosis is based on clinical and laboratory criteria, defined by strict guidelines. The original clinical and laboratory criteria for the identification of APS patients were published in 1999, in the so-called Sapporo criteria. In 2006 these criteria were revised, and recently more precise guidelines for analysis of the lupus anticoagulant have been provided. However, several questions related to the diagnosis of APS remain unanswered. CONTENT:In addition to providing a historical perspective, this review covers several challenges in the diagnosis of APS with respect to clinical and laboratory features, while highlighting pathogenic pathways of the syndrome. We discuss ongoing dilemmas in the diagnosis of this complex disease. Although antiphospholipid antibodies are found in association with various clinical manifestations, the older established clinical criteria were not substantively altered in the 2006 update. Several laboratory tests recommended in the latest criteria, including phospholipid-dependent coagulation tests for the detection of the lupus anticoagulant and ELISAs for measuring anticardiolipin and beta2-glycoprotein I antibodies, still show methodological and diagnostic shortcomings. In addition, antiphospholipid antibodies have been described against other antigens, but their clinical role remains uncertain. CONCLUSIONS:Despite updated APS criteria, diagnosis of this syndrome remains challenging. Further research on clinically relevant antibodies and standardization of their detection are needed to improve clinical risk assessment in APS.
journal_name
Clin Chemjournal_title
Clinical chemistryauthors
Devreese K,Hoylaerts MFdoi
10.1373/clinchem.2009.133678subject
Has Abstractpub_date
2010-06-01 00:00:00pages
930-40issue
6eissn
0009-9147issn
1530-8561pii
clinchem.2009.133678journal_volume
56pub_type
杂志文章,评审abstract：:With the ultramicroanalytical system described here we can measure glucose in 1 microL of plasma or serum. The sample is placed on a dry, multilayer film element (Eastman Kodak), where a colored spot about 3.5 mm in diameter develops. The reflectance of these spots is measured with a reflectance digital matrix photome...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1983-12-01 00:00:00
abstract：BACKGROUND:Group B streptococcal infections are the leading cause of sepsis and meningitis in newborns. A rapid and reliable method for the detection of this pathogen at the time of delivery is needed for the early treatment of neonates. Isothermal amplification techniques such as recombinase polymerase amplification h...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：10.1373/clinchem.2013.213504
更新日期：2014-04-01 00:00:00
abstract：BACKGROUND:The recent interest of clinical laboratories in developing serum testosterone assays based on isotope dilution-liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS) stems from the lack of accuracy of direct immunoassays. In this study, we assessed the accuracy and state of standardization (traceabilit...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：10.1373/clinchem.2008.105841
更新日期：2008-08-01 00:00:00
abstract：BACKGROUND:To address the continuing need for the standardization of clinical human cardiac troponin I (cTnI) assays, NIST, with the assistance of the AACC/IFCC Cardiac Troponin I Standardization Committee, has developed a new certified reference material, Standard Reference Material (SRM) 2921: Human Cardiac Troponin ...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：10.1373/clinchem.2005.051359
更新日期：2006-02-01 00:00:00
abstract：:We describe a novel assay for measuring glycohemoglobin directly from anticoagulated whole blood with the Abbott IMx analyzer. The glycohemoglobin is labeled with a soluble polyanionic affinity reagent and the anionic complex is then captured with a cationic solid-phase matrix. Glycohemoglobin is quantified by measuri...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1993-10-01 00:00:00
abstract：:Even though significant progress has been made in the development of electrodes for the in vivo detection of catecholamines, oxygen, and various cations, there has been little research on the feasibility of continuously monitoring drugs in whole blood by electrochemical sensing devices. Electroanalytical problems asso...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1982-09-01 00:00:00
abstract：BACKGROUND:Dried blood spots (DBS) are a convenient and inexpensive method for biobanking. Although many countries have established population-based DBS biobanks from neonatal screening programs, the quality and usefulness of DNA from DBS have not been extensively assessed. METHODS:We compared 4 common DNA extraction ...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：10.1373/clinchem.2007.087510
更新日期：2007-08-01 00:00:00
abstract：:The aim of this investigation was to study the distribution of arsenic species in human organs following fatal acute intoxication by arsenic trioxide. The collected autopsy samples of most organs were ground and dried, and the total arsenic was measured by electrothermal atomic absorption spectrometry (ETAAS). The ars...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1999-02-01 00:00:00
abstract：:A reaction of urea, o-phthalaldehyde and N-(1-naphthyl)ethylenediamine is described for measurement of urea by manual, continuous-flow, and kinetic methods. The continuous-flow system requires 25 mu-l of sample; 40 samples can be analyzed per hour. The kinetic method requires no enzymes, has no lag phase, and has good...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1975-07-01 00:00:00
abstract：:A modified heparin-Sepharose affinity chromatography procedure (Boberg et al., J. Lipid Res. 18:544-547, 1977) was developed to determine two different triglyceride lipase activities in human post-heparin plasma: hepatic triglyceride lipase (I) and lipoprotein lipase (II). With this procedure, lipoproteins were separa...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1981-05-01 00:00:00
abstract：:We report a continuous-flow fluorometric method for total urinary estrogens that involves the Kober reaction, with extraction of the reaction product into dichloroethane containing trichloroacetic acid as described by Hahnel and Jones [Clin. Chim. Acta 16, 185 (1967)]. The dichloroethane extraction gives greater stabi...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1977-10-01 00:00:00
abstract：:I describe the automation/mechanization of several areas of sample processing at SmithKline Beecham Clinical Laboratories. By analyzing and implementing new systems for conveyance and sorting of incoming specimens, specimen processing, within-laboratory specimen delivery, specimen storage and retrieval, and client res...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1990-09-01 00:00:00
abstract：:Four routine assays commonly used for monitoring plasma methotrexate (MTX) during high-dose therapy were validated by HPLC as the comparison method. MTX and its main metabolite, 7-hydroxymethotrexate (7-OHMTX), were analyzed by HPLC with postcolumn derivatization and fluorometric detection. About 200 clinical plasma s...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1996-01-01 00:00:00
abstract：BACKGROUND:Measurement of plasma renin is important for the clinical assessment of hypertensive patients. The most common methods for measuring plasma renin are the plasma renin activity (PRA) assay and the renin immunoassay. The clinical application of renin inhibitor therapy has thrown into focus the differences in i...
journal_title：Clinical chemistry
pub_type： 杂志文章,评审
doi：10.1373/clinchem.2008.118000
更新日期：2009-05-01 00:00:00
abstract：:Ethchlorvynol is a commonly abused sedative hypnotic. I report here a seven-day study of serum ethchlorvynol concentrations in a patient who had received an extreme overdose. These concentrations were correlated with the patient's response to stimuli. Serum ethchlorvynol concentrations were logarithmically related to ...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1975-06-01 00:00:00
abstract：:Determination of the ratio of testosterone to epitestosterone (T/E) in urine is used to detect testosterone administration in athletes, with a ratio > 6 considered as evidence of an offense. We show that administration of ketoconazole, which inhibits testosterone biosynthesis, may be useful for differentiating between...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1993-09-01 00:00:00
abstract：BACKGROUND:The resurgence of the parasitic disease schistosomiasis calls for more efficient diagnostic tests. We developed a rapid, simple, portable, and sensitive immunoagglutination assay that uses SiO(2) particles and quartz crystal microbalance (QCM) for quantifying Schistosoma japonicum (Sj) antibodies (SjAb). ME...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：10.1373/clinchem.2006.071555
更新日期：2006-11-01 00:00:00
abstract：:We report the development and characterization of an IRMA for the direct measurement of nicked human chorionic gonadotropin (hCGn) in blood and urine. hCGn derived from a reference preparation of hCG used as an immunogen elicits monoclonal antibodies (mAbs) with enhanced recognition of human luteinizing hormone epitop...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1999-01-01 00:00:00
abstract：BACKGROUND:Risk assessments of patients should be based on objective variables, such as biological markers that can be measured routinely. The acute response to stress causes the release of catecholamines from the adrenal medulla accompanied by chromogranin A (CGA). To date, no study has evaluated the prognostic value ...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：10.1373/clinchem.2007.102442
更新日期：2008-09-01 00:00:00
abstract：:Single-spin density-gradient ultracentrifugation (DUC) has proven to be a reproducible method for detection of low-density-lipoprotein (LDL) heterogeneity. Recently another method has been described for this: gradient gel electrophoresis (GGE) of serum, a method that might be more suitable for screening. To gain insig...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1991-06-01 00:00:00
abstract：:Four double-monoclonal time-resolved immunofluorometric assays (TrIFMAs) have been developed for the specific determination of pregnancy-associated plasma protein A/proeosinophil major basic protein (PAPP-A/ proMBP) complex in first-trimester maternal serum samples. The assays have a functional sensitivity of < 4 mIU/...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1997-12-01 00:00:00
abstract：:We evaluated a new multiple-channel chemistry analyzer, the Boehringer Mannheim "Diagnostic M." This instrument can perform 25 tests at the rate of 120 1.3-mL serum samples per hour. The instrument may be run in either a profile mode or single-test mode. In the single-test mode only the necessary reagent is pumped. th...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：:We modified a one-step, two-site, double monoclonal immunoenzymometric assay (Abbott Laboratories) for serum alpha1-fetoprotein (AFP) to increase its sensitivity and improve test precision at the low end. We increased sample size, incubation interval, and reaction time and temperature, and decreased the final reaction...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1987-04-01 00:00:00
abstract：BACKGROUND:Plasma creatinine concentration and calculated creatinine clearance are of limited value as glomerular filtration rate (GFR) markers in patients with decompensated liver cirrhosis. We assessed plasma cystatin C as an indicator of GFR in such patients. METHODS:We studied 36 patients with decompensated liver ...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：2002-06-01 00:00:00
abstract：:The precision of estimates of the sensitivity of diagnostic tests is evaluated. "Sensitivity" is defined as the fraction of diseased subjects with test values exceeding the 0.975-fractile of the distribution of control values. An estimate of the sensitivity is subject to sample variation because of variation of both c...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1985-04-01 00:00:00
abstract：:We evaluated a new commercially available partially purified reduced bovine hemoglobin solution (RBHS) and a new tonometer for use in the quality control of blood gas analyzers. RBHS is manufactured in three different formulations, each corresponding to three different bicarbonate-buffering capacities and concentratio...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1993-05-01 00:00:00
abstract：:We describe a modification of the MacGee method [Anal. Chem. 42, 421 (1970)] for rapid determination of phenytoin (diphenylhydantoin) in plasma by gas-liquid chromatography, in which an ethylaing reagent is used instead of the more common methylating reagents. With this modification, several N-methylated antiepileptic...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1975-05-01 00:00:00
abstract：:We report results for adjusted ionized calcium (at pH 7.4) and actual ionized calcium (at actual pH) in capillary blood from 183 patients with disorders of calcium metabolism (primary hyperparathyroidism, secondary hyperparathyroidism of malabsorption, primary hypoparathyroidism, Paget's disease, acromegaly, hypercalc...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1990-03-01 00:00:00
abstract：:We describe the conjoint measurement in urine of the alcoholic catecholamine metabolites 3,4-dihydroxyphenylglycol (DHPG) and 3-methoxy-4-hydroxyphenylglycol (MHPG). The method involves extraction with ethyl acetate and back-extraction into acetic acid (MHPG), followed by adsorption onto alumina (DHPG). The separation...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1988-05-01 00:00:00
abstract：:The accuracy of estimates of blood-alcohol concentration based on measurements of breath-alcohol concentration in a randomly selected subject by a random quantitative evidential breath-alcohol analyzer is evaluated with respect to the breath analyzer itself, its calibration, and the biological variables of the subject...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1987-02-01 00:00:00
