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The diagnosis of the antiphospholipid syndrome (APS) remains a work in progress. Revised criteria for diagnosis, published in 2006 (J Thromb Haemost 2006; 4:295), include vascular thrombosis, pregnancy morbidity, and abnormal laboratory tests (lupus anticoagulant, high-titer anticardiolipin antibodies, or anti-β2 glycoprotein I antibodies). However, many patients whose clinical presentation is consistent with APS fail to meet either the clinical or laboratory criteria.
In a study of 55 patients who met the laboratory criteria for APS, 30 did not meet the clinical criteria after a median follow-up of 5.4 years. However, these 30 patients had other immune-mediated disorders such as thrombocytopenia (17), autoimmune hemolytic anemia (9), or bot…