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•• Systematic review of literature between 1988 and 2000 involving 25 studies and 4184 patients with 3151 controls that has demonstrated that lupus anticoagulant LA positivity and medium-to-high titres of anticardiolipin antibodies aCLs were useful in picking out patients who were at greatest risk of thrombosis
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•• Meta-analysis of 25 studies between 1975 and 2003 of recurrent fetal loss RFL in women without autoimmune disease. Authors divided RFL into early <13 weeks and late <24 weeks. They found that there was a strong, consistent and significant association between RFL and LA. aCL was significantly associated with both early and late RFL
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• This quality assurance program run by the Royal Australasian College of Pathologists in 2002 demonstrated a high laboratory variation of numerical results, notable method-based variation and a general lack of consensus in semiquantitative reporting of aCL and β2-glycoprotein-I β2GP-I
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Favaloro EJ, Wong RC, Silvestrini R, McEvoy R, Jovanovich S, Roberts-Thomson P. A multilaboratory peer assessment quality assurance program-based evaluation of anticardiolipin antibody, and β2-glycoprotein I antibody testing. Semin. Thromb. Hemost. 31(1), 73-84 (2005). • This quality assurance program run by the Royal Australasian College of Pathologists in 2002 demonstrated a high laboratory variation of numerical results, notable method-based variation and a general lack of consensus in semiquantitative reporting of aCL and β2-glycoprotein-I (β2GP-I).
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• Study to determine the prevalence of anti-β2GP-I in a cohort of patients n = 418 with APS and SLE. The authors found that anti-β2GP-I was present in 44.5% of the cohort, especially the Caucasians. Persistent positivity of IgG anti-β2GP-I was associated with venous thrombosis and IgM anti-β2GP-I with arterial thrombosis
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• Seminal paper n = 90 that concluded that treatment with aspirin and heparin leads to a significantly higher rate of live births in women with a history of recurrent miscarriage associated with PLs than that achieved with aspirin alone. There was no difference in outcome between the two treatments in pregnancies that advanced beyond 13 weeks' gestation
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• Double-blind randomized controlled trial n = 50 carried out in a tertiary obstetric hospital and recurrent miscarriage clinic on women with aPLs but no SLE or thrombotic APS concluded that 85% of the placebo group 17 out of 20 and 80% of the aspirin-treated group 16 out of 20 were delivered of live infants. This suggests that low-dose aspirin has no additional benefit when added to supportive care for women for whom recurrent early fetal loss is the only sequela of the APS
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