detection of anticardiolipin antibodies

Last reviewed 01/2018

The earlier VDRL test using cardiolipin as antigen is insensitive. Modern procedures use solid-phase radioimmunoassay - RIA - or enzyme linked immunoabsorbent assay - ELISA.

• anticardiolipin ELISA is thought to have high sensitivity but low specificity
• a positive test is strongly associated with morbidity in pregnancy than with thrombosis (1)

Since 1990, reporting of results have been standardised and are expressed in terms of GPL or MPL units.

The risk of thrombosis or spontaneous abortion increases with the titre of aCL and are greater with IgG antibodies than with IgM - for example, of 39 patients with IgG greater than 20 GPL units, 70% had a thrombotic event.

Reference:

• (1) Cohen D et al. Diagnosis and management of the antiphospholipid syndrome. BMJ. 2010;340:c2541