Selected studies of isolated IgM antibodies in APS
| . | Type of study . | Patient selection . | N . | Findings . |
|---|---|---|---|---|
| Rodriguez-Sanz9 | Observational, cross-sectional | >55 years Acute brain infarct | 255 (161 male) | • 22 APS (4 before IS, 18 after) • IgM aCL within 48 h of admission correlate with admission NIHSS by MVA • IgG aCL within 48 h of admission correlate with 3-month mRS by MVA |
| Del Ross10 | Retrospective | APS/thrombosis | 106 (81 female) | • VTE = 55, ATE = 48, small vessel = 3 • 13 single positive for IgM (12.3%) • Single IgM stable over mean of 10.4 yr • Single IgM were significantly older and had increased retinal vein thrombosis |
| Sahebari11 | Cross-sectional | Neurological disorder and ≥1 aPL | 100 | • IgM anti-β2GPI positive in 100% of optic neuritis • IgM aCL was most common antibody in stroke patients |
| Urbanski12 | Retrospective | Single-positive IgM aCL or anti-β2GPI vs IgM aPL with ≥1 other aPL | 168 | • 24 patients with isolated IgM APS (9 isolated aCL, 2 isolated anti-β2GPI) • IgM only were older • Isolated IgM more common in stroke (OR 3.1; 95% CI 1.2-1.9; P = 0.18) • Single IgM positivity persisted in 70% |
| Chayoua13 | Retrospective | Multicenter study of APS samples | 1008 (763 female) | By MVA • LAC: OR 2.3 (95% CI 1.6-3.3) to 2.4 (95% CI 1.7-3.4) • IgG aCL or anti-β2GPI: OR 2.3 (95% CI 1.6-3.5) to 3.2 (95% CI 2.0-5.0) • IgM aCL or anti-β2GPI: NS • Isolated IgM aCL or anti-β2GPI in 3.5%-5.4% |
| . | Type of study . | Patient selection . | N . | Findings . |
|---|---|---|---|---|
| Rodriguez-Sanz9 | Observational, cross-sectional | >55 years Acute brain infarct | 255 (161 male) | • 22 APS (4 before IS, 18 after) • IgM aCL within 48 h of admission correlate with admission NIHSS by MVA • IgG aCL within 48 h of admission correlate with 3-month mRS by MVA |
| Del Ross10 | Retrospective | APS/thrombosis | 106 (81 female) | • VTE = 55, ATE = 48, small vessel = 3 • 13 single positive for IgM (12.3%) • Single IgM stable over mean of 10.4 yr • Single IgM were significantly older and had increased retinal vein thrombosis |
| Sahebari11 | Cross-sectional | Neurological disorder and ≥1 aPL | 100 | • IgM anti-β2GPI positive in 100% of optic neuritis • IgM aCL was most common antibody in stroke patients |
| Urbanski12 | Retrospective | Single-positive IgM aCL or anti-β2GPI vs IgM aPL with ≥1 other aPL | 168 | • 24 patients with isolated IgM APS (9 isolated aCL, 2 isolated anti-β2GPI) • IgM only were older • Isolated IgM more common in stroke (OR 3.1; 95% CI 1.2-1.9; P = 0.18) • Single IgM positivity persisted in 70% |
| Chayoua13 | Retrospective | Multicenter study of APS samples | 1008 (763 female) | By MVA • LAC: OR 2.3 (95% CI 1.6-3.3) to 2.4 (95% CI 1.7-3.4) • IgG aCL or anti-β2GPI: OR 2.3 (95% CI 1.6-3.5) to 3.2 (95% CI 2.0-5.0) • IgM aCL or anti-β2GPI: NS • Isolated IgM aCL or anti-β2GPI in 3.5%-5.4% |
aCL, anticardiolipin antibodies; aPL, antiphospholipid antibodies; APS, antiphospholipid syndrome; ATE, arterial thromboembolism; β2GPI, β2-glycoprotein I; h, hours; IS, ischemic stroke; LAC, lupus anticoagulant; mRS, modified Rankin scale; MVA, multivariate analysis; NIHSS, NIH stroke scale; NS, not significant; OR, odds ratio; VTE, venous thromboembolism.