Anticardiolipin antibodies and recurrent early pregnancy loss: a century of equivocal evidence.

Abstract:

:In 1987, Nigel Harris cautioned against over-diagnosing the antiphospholipid syndrome (APS). In what was a rather prophetic editorial titled 'The Syndrome of the Black Swan', he suggested that while patients with APS do indeed exist, they are probably much more unusual than many medical professionals might like to believe. He expressed concern that the value of studying antiphospholipid antibodies (aPLs) as interesting non-organ specific autoantibodies, would become lost in a 'sea of over-interpreted and over-reported laboratory and clinical findings'. It is our contention that 25 years later, this prediction has come to pass, particularly with respect to one type of aPL and its relation to a clinical event, namely anticardiolipin antibodies and early recurrent pregnancy loss. In this commentary, we trace the evolution of the current dogma and propose that reevaluation of available data from an alternative perspective results in quite a different understanding, the acceptance of which would necessitate not only a revision of the classification criteria for APS but also the subsequent revision of many diagnoses.

journal_name

Hum Reprod Update

authors

Clark CA,Laskin CA,Spitzer KA

doi

10.1093/humupd/dms020

subject

Has Abstract

pub_date

2012-09-01 00:00:00

pages

474-84

issue

5

eissn

1355-4786

issn

1460-2369

pii

dms020

journal_volume

18

pub_type

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