Antiphospholipid (APL) antibody-IgG

What is the Antiphospholipid antibody-IgG test?

The Antiphospholipid Antibody testing is a blood test used to determine an autoimmune disorder called Antiphospholipid Syndrome (APS). This systemic autoimmune disease causes an increased risk of blood clot formation along with a risk of pregnancy complications resulting in early miscarriages or fetal losses.

The immune system generally produces an antibody in response to a foreign invasion on the system. Antiphospholipid antibodies are created when the immune system mistakes a part of the body like an invading element and works against it. In this case, the APL antibodies work against fat cells containing phosphorus. These cells are known as phospholipids and are a part of the blood vessels.

At present, there is no cure for this condition but there are medications that can reduce the risk of blood clot formations. Up to one in three cases of stroke under the age of 50 years may be due to this syndrome. If a blood clot is formed in the legs, it can lead to deep vein thrombosis (DVT), whereas in the brain, it can lead to a stroke. Severe cases of DVT can also lead to pulmonary embolism or blood clots in the lung which is a life-threatening condition.

This happens when a segment of the clot formed in a vein breaks off and travels through the body and blocks off an artery feeding the lungs. A large percentage of patients diagnosed with APS have heart valve abnormalities. The condition also leads to a drop in platelet count which can result in abnormal bleedings.

In a small minority of patients with APS, a catastrophic antiphospholipid syndrome, often termed as “thrombotic storm” is witnessed. This results in the formation of several clots all through the system resulting in multiple organ failures. This is a condition that is treated as a medical emergency and the patient needs intensive care at the earliest.  While APL can be present in the blood for long periods, this sort of event only occurs occasionally.  Many people with cancer or systemic lupus erythematosus can also have these antibodies. The condition affects women much more than it affects men. While the symptom has a genetic component, it is not usually carried from the parent to the offspring.

The three common forms of APS antibodies are lupus anticoagulant, beta-2 glycoprotein I (β2GPI) and anticardiolipin antibodies. In many cases, multiple tests are done at an interval to confirm

Why do I need to undergo an antiphospholipid antibody-IgG test?

The test is ordered to determine the cause of the following symptoms.

– Inappropriate blood clot formations or excessive clotting.

– Recurrent episodes of miscarriage.

– Low platelet count or thrombocytopenia.

– A stroke or a transient ischemic attack.

– A red skin rash that can develop in a lacy, net-like pattern.

– Neurological symptoms including chronic headaches, including migraines, dementia, and seizure. In some cases, issues related to balance and mobility can also occur.

– Excessive bleeding including bleeding from nose and gums.

– Women with repeated miscarriages and stillbirths. The condition can also lead to high blood pressure in pregnancy or early births.

While many people with the antibody may not show any symptoms, others, especially those with lupus, can develop a rash, joint pains, migraines and feel very tired. It is also common for people with APS to show forgetfulness, confusion, and anxiety leading to memory lapses.

How is an Antiphospholipid antibody-IgG test performed?

The test is performed by collecting a blood sample from the patient through the process of venipuncture. A needle is inserted into a suitable vein to draw the required volume of blood. The process involves the following steps.

– An elastic band is tied around the upper arm to make the veins swell with blood, thus making them more visible. The collection site is generally picked around the elbow region and the healthcare practitioner disinfects the area where the needle will be inserted to prevent any chance of infection.

– A needle is inserted into the vein and the required volume of blood is drawn through it in an attached tube. A prick or a stinging sensation is usually felt when the needle is inserted.

– The band around the arm is unfastened and the needle is then withdrawn. The pressure is applied on the collection site through a gauze or a cotton piece to prevent excessive bleeding. The spot is then covered with a sterile bandage and the sample is sent to the laboratory for testing.

– The process of blood collection is safe and simple and is generally concluded within a few minutes. As the size of veins varies from one person to another, the process may be difficult for some patients and multiple punctures may be needed before the right vein is found. Some patients might feel dizzy or lightheaded after the collection process and may need special care.

– Any soreness or bruising in and around the collection site normally gets cured within a few days. In some rare cases, an infection or excessive bleeding may occur and that needs medical attention.

What is the price for the antiphospholipid antibody-IgG test in India? 

The price of the test varies from Rs 600 to Rs 2500 depending on the location of the center and the facilities provided.

When will I get the test results?

The test results are generally delivered within 24 hours. Some centers may take a longer time.

What is the normal range for the Antiphospholipid antibody-IgG test?

Among the three tests for APS, the lupus anticoagulant test gives a positive or negative result. The remaining two provides the results in numbers. The test results can vary depending on the age, gender, health history of the patient and also on the method used for the test. A standard range of the levels is mentioned below as reference. The higher the numerical value the more are the number of antibodies present in the blood.

– 0-39.9 MPL or GPL (weakly positive)
– 0-79.9 MPL or GPL (positive)
– ≥80.0 MPL or GPL (strongly positive)

MPL refers to IgM Phospholipid units and one MPL unit is 1 microgram of IgM antibody.GPL refers to IgG Phospholipid units and one GPL unit is 1 microgram of IgG antibody. The test results are to be compared with multiple other factors and interpreted by a doctor to make the right diagnosis.

What do the results mean?

The positive and strongly positive results are generally considered as the sign of APS. In such cases, a doctor will analyze the patient’s medical history and prescribe medications to thin the blood in order to reduce the chance of clotting. The patient will need to continue this medication for the rest of his life. For any woman diagnosed with APS, proper planning is needed before pregnancy.

The treatment will start before pregnancy and continue until the delivery. In some cases, an elevated level of APL antibodies can occur in the blood due to an infection or some specific medications. In such cases, repeat tests might be ordered to recheck the levels after a certain period.

The main goal of the treatment is to prevent blood clots from forming and keep existing clots from getting larger. In case APS is connected with another autoimmune disorder like lupus, the treatment of the same is also necessary. In many cases the doctors also order for regular complete blood counts after APS is diagnosed, to check the platelet levels.

Do I need to fast for the Antiphospholipid antibody-IgG test?

No dietary restrictions or special preparations are required for the test.

What else do I need to know before I appear for an Antiphospholipid antibody-IgG test?

The following points can be kept in mind before appearing for the test.

– APS can result in a stroke even in a young person without any prior history of cardiac ailments.

– Symptoms include sudden numbness, weakness or paralysis of your face, arm or leg, difficulty in speaking or understanding speech, visual disturbances and severe headache. In these cases, one should immediately seek medical attention.

– APS can be diagnosed in any age group, from infants to the elderly, but is most commonly found in people aged 20 to 50 and especially in women.

Before the test, it is necessary to discuss all the types of medications that you are consuming, with your doctor. Medicines like medicines, such as quinidine, procainamide, phenytoin, penicillin and viral infections such as HIV can raise the antibody levels. Once diagnosed with APS certain lifestyle changes may be instructed by the doctor. These may include dietary changes and modification of smoking habits.

Can pregnant women undergo an Antiphospholipid antibody-IgG test?

Pregnant women can undergo the test without any restrictions.