Some indications to test for antiphospholipid antibodiesa
| Unprovoked deep vein thrombosis or pulmonary embolism (Antiphospholipid antibody testing is not recommended in patients with provoked venous thrombosis, as there is insufficient evidence to recommend long-term anticoagulation.) |
| Ischemic stroke (including transient ischemic attack) in patients under age 50 |
| Patients with both arterial and venous events |
| Recurrent thrombosis |
| Thrombosis in an unusual site |
| Pregnancy morbidity (1 or more unexplained deaths of a morphologically normal fetus at or beyond the 10th week of gestation; 1 or more premature births of a morphologically normal neonate before the 34th week of gestation because of preeclampsia, eclampsia, or placental insufficiency; or 3 or more unexplained consecutive spontaneous abortions before the 10th week of gestation) |
| All patients with systemic lupus erythematosus |
↵a Knowledge of the antiphospholipid antibody status helps to decide if low-dose aspirin should be recommended for primary prevention of thrombosis.32 Lupus anticoagulant is likely to be falsely positive in those with acute thrombosis and those receiving anticoagulant therapy. Hence, anticoagulant therapy should be interrupted for at least 7 days before testing for lupus anticoagulant. However, anticardiolipin and anti-beta-2 glycoprotein I can be tested at any time, as they are not affected by thrombosis or anticoagulant therapy.