SINGLE ANTICARDIOLIPIN MEASUREMENT IN THE ROUTINE MANAGEMENT OF PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS

Objective. To examine the usefulness of a single measurement of antica rdiolipin antibodies (aCL) in systemic lupus erythematosus (SLE) in ro utine clinical practice. Methods. All 127 patients with SLE currently followed by our rheumatology unit had an aCL measurement on routine cl inic review. Their charts were then reviewed for specific disease mani festations. Basic statistical correlations of the aCL result and the s pecific disease manifestations were performed, and the clinical utilit y of the aCL test assessed using Bayesian analysis. Results. aCL was p ositive (> 2 SD) in 24% and was associated with recurrent fetal loss, thrombosis, cerebrovascuIar disease, livedo reticularis and digital in farcts. Bayesian analysis showed that a single positive aCL test incre ased the relative and absolute risk of ah the above complications. The criterion of aCL positivity as > 15 units (2 SD) was associated with the highest relative risk. Conclusion. A single positive aCL test in r outine management of SLE is a useful predictor of important clinical e vents.