APS Tests

You must fail one or more of the following tests on two separate occasions, at least 8 weeks apart, to qualify as someone with APS. (Other sources acknowledge the waxing and waning of the disease, stating that just because you don’t test positive on every test doesn’t mean you don't have APS)

• aPTT - activated partial thromboplastin times
• if too high, the blood particles are sticking to each other too much
• only sensitive to 30%of APS.
• dRVVT - Dilute Russell Viper Venom Time
• Kaolin Clotting Time - very sensitive to APS but from comments I am guessing it is expensive
• Platelet Neutralization Test
• Hexagonal Phase Phospholipid - Only valid tests for Lupus inhibitors when patients are on anticoagulants
• Acl or ACA - Anticardiolipin Antibody - Can be done on plasma that is anticoagulated
• Specific isotopes = IgG, IgM, IgA
• Risk of deep vein thromboses with IgG=5.3 greater
• LA - Lupus Anticoagulant
• For those with accelerated arterial disease, the anti-oxLDL and anti-LP(a) tests may be requested

In addition to the above, for a diagnosis of active APS, you must have

• a history of thromboses (blood clots),
• thrombocytopenia (low platelet count), or
• recurrent pregnancy loss

The tests are either coagulation based or antibody based. In Coagulation Tests the phospholipids in your blood will be evaluated to see if there are antibodies clinging to them. These antibodies interfere with the time it takes for blood to clot. The blood is tested at 30 minute intervals for 2 hours. The pattern of when it clots determines, in part, the disorder. The longer it takes to clot, the greater the chance of having a clotting disorder …in this case, APS

Treatment

The Specialists usually consulted are the Rheumatologist (joints and soft tissues expert) and the Hematologist (blood disease expert) because of their greater familiarity with autoimmune disorder. However, the family physician is often very able to order the tests and monitor the medicines

There are three anti-coagulants frequently employed in treating APS. These are sometimes called “blood thinners”

• Aspirin (“baby” aspirin to full dose)
• Warfarin/Coumadin
• Heparin - only available by injection

If you take Warfarin/Coumadin or Heparin you may need regular blood checks to determine your INR. The INR (International Normalized Ratio) compares your blood’s tendency to clot with a standardized blood result. Also, be very careful about all natural/herbal and over the counter drugs that you take because there is a wide range of contra-indicated substances when you are on Coumadin