Avances en la identificación del síndrome antifosfolípido: Nuevos criterios de laboratorio para su diagnóstico

Abstract

Antiphospholipid syndrome (APS) is an autoimmune disease characterized by thrombosis and/or obstetric morbidity and the persistent presence of antiphospholipid antibodies (aPL). Limitations in diagnosis have led to the evaluation of the applicability of the new ACR/EULAR 2023 criteria compared to the Sapporo criteria (2006), in addition to the search for new biomarkers. The new criteria demonstrated higher specificity (99%) although lower sensitivity (86%), virtually eliminating false positives. The inclusion of new clinical domains such as thrombocytopenia, cardiac valvular involvement, and livedo racemosa allows for the reclassification of previously excluded patients. Likewise, noncriteria antibodies (aPS/PT, aAnxV, aPE, aVim/CL) were analyzed, which are especially useful for seronegative patients, revealing notable prevalences significantly associated with typical APS events. The results show that the new criteria improve diagnostic specificity by integrating relevant clinical manifestations, as well as enhancing the scoring system for biomarker identification.The integration of new biomarkers has made it possible to identify many patients with suggestive features of APS, highlighting the need to include them in established criteria in order to improve the standardization of their detection methods for a more complete and accurate classification of APS.