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© Dirk Biddle
Anti-cardiolipin antibodies (ACAs - IgA, IgG, and IgM) are the most commonly detected of the circulating autoantibodies to phospholipids (The major structural lipid of most cellular membranes ( except the chloroplast which has galactolipids). Contain phosphate , usually as a diester. (OMD).Any of numerous lipids (as lecithins and phosphatidylethanolamines) in which phosphoric acid as well as a fatty acid is esterified to glycerol and which are found in all living cells and in the bilayers of cell membranes. (M+)), the other most recognised being the lupus-like anticoagulant (a heterogenous group of IgG or IgM antibodies). ACA is strongly associated with venous and arterial thrombosis, thrombocytopenia and miscarriage. The mechanism of action of antiphospholipid antibodies is not known. The simplest theory is that there is an antibody directed against the patient’s own platelet and endothelial cell phospholipids that cause platelet aggregation and subsequent vascular occlusion. This also accounts for thrombocytopenia seen in patients but does not account for its association in inflammatory vasculitis conditions. However, IgG ACA has been associated with thrombotic outcomes in Systemic lupus erythematosus, Sjögren's syndrome, and Scleroderma (1), and elevated levels of IgA ACA have been associated with cutaneous leukocytoclastic vasculitis (2) Kawasaki disease (3) Wegener’s granulomatosis, Giant cell arteritis, Polymyalgia rheumatica, and Behcet’s disease (4) but not with thrombosis in these conditions (5).
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1. http://www.uveitis.org/medical/articles/case/antiphospholipid_syndrome.html
2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8784278&dopt=Abstract
3. http://www.karger.com/Article/FullText/63118
4. http://neuroland.com/cvd/aps.htm
5. http://rheumatology.oupjournals.org/cgi/content/full/39/5/568#R7
Testing information: http://www.aruplab.com/guides/clt/tests/clt_al70.jsp#3965115
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