Lupus Anticoagulants and Antibodies to Phospholipids-Reply

Douglas A. Triplett, MD; John T. Brandt, MD
JAMA. 1988;259(20):2997. doi:10.1001/jama.1988.03720200018016.
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In Reply.  —Blitz et al correctly emphasize the current uncertainty associated with the laboratory performance and interpretation of antiphospholipid antibody studies. There is currently no approved commercial assay system for antiphospholipid antibody, although several manufacturers appear close to marketing enzyme-linked immunosorbent assays. The availability of standardized kits should alleviate many of the procedural problems that have been encountered and described. However, acceptable (or standardized) reference serum samples for antiphospholipid antibody will be needed to calibrate these systems.1The lack of thrombosis seen in association with antiphospholipid antibody and infectious diseases or drug-induced antiphospholipid antibody remains puzzling and controversial. Although there is apparent agreement regarding an absence of thrombosis with antiphospholipid antibody complicating infectious disease, we found that drug-induced antiphospholipid antibodies were associated with thrombosis. Our findings are in contrast to those of Canoso and Oliveira.2 In our study, the use of a panel of negatively charged phospholipids did


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