cardiolipin-antistoffer (LH Indholdsside)

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      <HtmlField Name="PageContent"><![CDATA[<h2>Resum&eacute;</h2>
<ul>
    <li>Cardiolipin antistoffer kan v&aelig;re medvirkende &aring;rsag&nbsp;til forekomst af&nbsp;trombose, cerebrale infarkter&nbsp;eller bl&oslash;dningsforstyrrelser. </li>
    <li>Analysen indg&aring;r i udredningen af trombofiliudredning og&nbsp;<a href="http://https://www.sundhed.dk/sundhedsfaglig/laegehaandbogen/blod/tilstande-og-sygdomme/koagulationsforstyrrelser/antiphospholip-antistof-syndrom/">Antifosfolipid syndrom</a>, prim&aelig;rt eller sekund&aelig;rt</li>
</ul>
<h2>Definition<a href=" " title="Lyngbye J, Kjær A, Ladefoged S, Nissen PH. Lyngbyes laboratoriemedicin. 2. udg. København: Nyt Nordisk Forlag Arnold Busck A/ S; 2010" data-url="reference-link" data-value-piped="Lyngbye J, Kjær A, Ladefoged S, Nissen PH|Lyngbyes laboratoriemedicin. 2. udg|København|Nyt Nordisk Forlag Arnold Busck A/ S|2010" data-value="Lyngbye J, Kjær A, Ladefoged S, Nissen PH. Lyngbyes laboratoriemedicin. 2. udg. København: Nyt Nordisk Forlag Arnold Busck A/ S; 2010" data-type="book-reference">1</a>,<a href=" " data-type="journal-reference" data-value="Bradacova P, Slavik L, Ulehlova J, Skoumalova A, Ullrychova J, Prochazkova J, Hlusi A, Manukyan G, Kriegova E, Current Promising Biomarkers and Methods in the Diagnostics of Antiphospholipid Syndrome: A Review. Biomedicines 2021;9: " data-value-piped="Bradacova P, Slavik L, Ulehlova J, Skoumalova A, Ullrychova J, Prochazkova J, Hlusi A, Manukyan G, Kriegova E|Current Promising Biomarkers and Methods in the Diagnostics of Antiphospholipid Syndrome: A Review.|Biomedicines|2021|9||33567576" data-url="reference-link" data-pubmedid="33567576" title="Bradacova P, Slavik L, Ulehlova J, Skoumalova A, Ullrychova J, Prochazkova J, Hlusi A, Manukyan G, Kriegova E, Current Promising Biomarkers and Methods in the Diagnostics of Antiphospholipid Syndrome: A Review. Biomedicines 2021;9: ">2</a></h2>
<ul>
    <li>Cardiolipin er et fosfolipid, som er en vigtig bestanddel af den indre mitochondrie membran</li>
    <li>Cardiolipin antistoffer en del af en gruppe af antistoffer rettet mod fosfolipid-bindende proteiner, eksempelvis ogs&aring; LUPUS-antikoagulans og beta-2-Glycoprotein 1. Cardiolipin antistoffer binder til ApoH, et&nbsp;kompleks, som h&aelig;mmer Protein C.&nbsp; </li>
    <li>Cardiolipin antistoffer kan v&aelig;re af typerne IgG, IgM og (IgA)</li>
    <li>M&aring;ling af Cardiolipin-antistoffer er s&aelig;dvanligvis af typerne IgG og IgM</li>
</ul>
<h2>Synonymer</h2>
<ul>
    <li>Synonymer: ACA; anticardiolipin antistoffer; anticardiolipin; antifosfolipid-antistoffer; cardiolipin antistoffer</li>
</ul>
<h2>Indikationer&nbsp;<a href="EditorPage.aspx?da=core&amp;id=%7BEBCCED0F-591D-4F9F-86A9-BD27C20D60FE%7D&amp;ed=FIELD8091163953&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H8091167362&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Garcia D, Erkan D, Diagnosis and Management of the Antiphospholipid Syndrome. N Engl J Med 2018;378: 2010-2021" data-value-piped="Garcia D, Erkan D|Diagnosis and Management of the Antiphospholipid Syndrome.|N Engl J Med|2018|378|2010-2021|29791828" data-url="reference-link" data-pubmedid="29791828" title="Garcia D, Erkan D, Diagnosis and Management of the Antiphospholipid Syndrome. N Engl J Med 2018;378: 2010-2021">5</a>,<a href="https://dsth.dk/pdf/Trombofili_Retningslinje_2020_Hoering.pdf" data-type="other-reference" data-value="Retningslinje DSTH" data-url="https://dsth.dk/pdf/Trombofili_Retningslinje_2020_Hoering.pdf" title="Retningslinje DSTH">3</a></h2>
<ul>
    <li>Udredning af&nbsp;<a href="http://https//www.sundhed.dk/sundhedsfaglig/laegehaandbogen/blod/tilstande-og-sygdomme/koagulationsforstyrrelser/antiphospholip-antistof-syndrom/">antifosfolipid syndrom</a>, prim&aelig;rt eller sekund&aelig;rt&nbsp;</li>
    <li>Trombofiliudredning
    <ul>
        <li>Spontan ven&oslash;s trombose/lungeemboli f&oslash;r 50-&aring;rs alderen
        <ul>
            <li>Fx P-pille induceret&nbsp;<a href="~/link.aspx?_id=BF5E7B69312249EE9C53E047D232216C&amp;_z=z">dyb venetrombose</a>&nbsp;(DVT)</li>
        </ul>
        </li>
        <li>Gentagne spontane ven&oslash;se tromboser</li>
        <li>Tromboser med us&aelig;dvanlig lokalisation fx arm-, nyre-, cerebral- eller mesenterialvener
        <ul>
            <li>Famili&aelig;r ophobning af trombosetilf&aelig;lde</li>
            <li>Gentagne spontane sene aborter</li>
            <li>Intrauterin v&aelig;ksth&aelig;mning, fosterd&oslash;d</li>
        </ul>
        </li>
    </ul>
    </li>
    <li>Tidlig og alvorlig&nbsp;<a href="~/link.aspx?_id=FC73B592428D4CD1ACFDD7CB901DB811&amp;_z=z">pr&aelig;eklampsi/eklampsi</a>&nbsp;<a href="http://www.dsth.dk/pdf/Rapporter_retningslinjer/03_GRAVID.pdf?e=2589360/7542775" title="Tromboemboligsk sygdom under graviditet og post partum - risikovurdering, profylakse og behandling. Retningslinje 2014. Dansk Selskab for trombose og hæmostase." data-url="http://www.dsth.dk/pdf/Rapporter_retningslinjer/03_GRAVID.pdf?e=2589360/7542775" data-value="Tromboemboligsk sygdom under graviditet og post partum - risikovurdering, profylakse og behandling. Retningslinje 2014. Dansk Selskab for trombose og hæmostase." data-type="other-reference">4</a></li>
    <li>Risikovurdering mht. tromboserisiko hos patienter med SLE</li>
</ul>
<h2>Fortolkninger<a href=" " data-type="journal-reference" data-value="Garcia D, Erkan D, Diagnosis and Management of the Antiphospholipid Syndrome. N Engl J Med 2018;378: 2010-2021" data-value-piped="Garcia D, Erkan D|Diagnosis and Management of the Antiphospholipid Syndrome.|N Engl J Med|2018|378|2010-2021|29791828" data-url="reference-link" data-pubmedid="29791828" title="Garcia D, Erkan D, Diagnosis and Management of the Antiphospholipid Syndrome. N Engl J Med 2018;378: 2010-2021">5</a>,<a href="https://dsth.dk/pdf/Trombofili_Retningslinje_2020_Hoering.pdf" data-type="other-reference" data-value="Retningslinje DSTH" data-url="https://dsth.dk/pdf/Trombofili_Retningslinje_2020_Hoering.pdf" title="Retningslinje DSTH">3</a></h2>
<ul>
    <li>Antikardiolipin-antistof IgG og/eller IgM i plasma i en medium eller h&oslash;j titer p&aring; enten&nbsp;over 40 IU/L eller over laboratoriets 99. percentil m&aring;lt to gange med mindst 12&nbsp;ugers interval indg&aring;r som et af de diagnostiske kriterier i udredningen af <a href="https://dsth.dk/pdf/Trombofili_Retningslinje_2020_Hoering.pdf">trombofili&nbsp;</a><a href=" " data-type="journal-reference" data-value="Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RH, DE Groot PG, Koike T, Meroni PL, Reber G, Shoenfeld Y, Tincani A, Vlachoyiannopoulos PG, Krilis SA, International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4: 295-306" data-value-piped="Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RH, DE Groot PG, Koike T, Meroni PL, Reber G, Shoenfeld Y, Tincani A, Vlachoyiannopoulos PG, Krilis SA|International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS).|J Thromb Haemost|2006|4|295-306|16420554" data-url="reference-link" data-pubmedid="16420554" title="Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RH, DE Groot PG, Koike T, Meroni PL, Reber G, Shoenfeld Y, Tincani A, Vlachoyiannopoulos PG, Krilis SA, International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4: 295-306">6</a></li>
    <li>&nbsp;&lt;20 x 103 int.enh./l: Ingen klinisk betydning</li>
    <li>20 - 40 x 103 int.enh./l: Lav risiko for trombose</li>
    <li>&gt;40 x 103 int.enh./l: H&oslash;j risiko for trombose</li>
</ul>
<h2>Fejlkilder (og kilder til normal variation)</h2>
<ul>
    <li>Der kan v&aelig;re krydsreaktion med andre antistoffer hvilket er afh&aelig;ngigt af assay. Kontakt lokalt laboratorium</li>
</ul>
<h2>Biokemisk baggrund<a href="EditorPage.aspx?da=core&amp;id=%7BEBCCED0F-591D-4F9F-86A9-BD27C20D60FE%7D&amp;ed=FIELD9207344989&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H9207345135&amp;us=sitecore%5Canvi&amp;mo&amp;pe=0&amp;fbd=1" title="Lyngbye J, Kjær A, Ladefoged S, Nissen PH. Lyngbyes laboratoriemedicin. 2. udg. København: Nyt Nordisk Forlag Arnold Busck A/ S; 2010" data-url="reference-link" data-value-piped="Lyngbye J, Kjær A, Ladefoged S, Nissen PH|Lyngbyes laboratoriemedicin. 2. udg|København|Nyt Nordisk Forlag Arnold Busck A/ S|2010" data-value="Lyngbye J, Kjær A, Ladefoged S, Nissen PH. Lyngbyes laboratoriemedicin. 2. udg. København: Nyt Nordisk Forlag Arnold Busck A/ S; 2010" data-type="book-reference">1</a></h2>
<ul>
    <li>Cardiolipin er et fosfolipid, som er en vigtig bestanddel af den indre mitochondrie membran</li>
    <li>Cardiolipin blev f&oslash;rst beskrevet i hjertev&aelig;v &ndash; deraf navnet</li>
    <li>Cardiolipin antistof indg&aring;r sammen med lupus antikoagulans i antiphospholipid syndromet (APS)
    <ul>
        <li>APS er karakteriseret ved recidiverende ven&oslash;s (og arteriel) trombose, symptomatisk placentainsufficiens - formentlig trombosebetinget (habituel abort, intrauterin v&aelig;ksth&aelig;mning, fosterd&oslash;d) og/eller&nbsp;<a href="~/link.aspx?_id=026432E5E02747B2945704079DC03E86&amp;_z=z">trombocytopeni</a></li>
        <li>APS optr&aelig;der hyppigst uden, at man kan p&aring;vise en tilgrundliggende sygdom (prim&aelig;r APS). APS kan ogs&aring; optr&aelig;de sekund&aelig;rt til cancer og autoimmunsygdomme (sekund&aelig;r APS) og specielt&nbsp;<a href="~/link.aspx?_id=68262A579C404E3B83DEDB66EB738254&amp;_z=z">systemisk lupus erythematosus (SLE)</a>, hvor incidensen er ca. 50 %</li>
        <li>APS uden klinisk relevans kan optr&aelig;de forbig&aring;ende ved infektioner og ved behandling med visse farmaka</li>
        <li>Antistofferne i APS&nbsp;fremmer formentlig trombedannelse ved at binde sig til fosfolipid-protein komplekser&nbsp;placeret p&aring;&nbsp;endotelceller og thrombocytter, hvilket starter en prokoagulant tilstand</li>
        <li>Cardiolipin antistoffer kan v&aelig;re af typen IgG og IgM (IgA)</li>
    </ul>
    </li>
    <li>Cardiolipin antistoffer og lupus antikoagulans er autoantistoffer rettet mod komplekser af phospholipid og visse plasmaproteiner (hyppigst &szlig;<sub>2</sub>-glykoprotein I og prothrombin)&nbsp;&nbsp;</li>
    <li>Cardiolipin antistoffer giver ligesom lupus antikoagulans falsk forl&aelig;nget APTT pga. antistoffer mod fosfolipid i reagenset &ndash; kan bruges til screening for APS</li>
</ul>
<h2>Pr&oslash;vetagning</h2>
<ul>
    <li>Veneblodpr&oslash;ve
    <ul>
        <li>Serum &ndash; r&oslash;r uden antikoagulans - r&oslash;d prop uden gel</li>
    </ul>
    </li>
</ul>
<h2>Referenceintervaller</h2>
<p>Da analysemetoden ikke er standardiseret og assays er meget forskellige b&oslash;r man konsultere lokalt laboratorium for g&aelig;ldende cut-off.</p>
<ul>
    <li>Cardiolipin-IgG;P &lt; 10 x 10<sup>3</sup> int.enh./L</li>
    <li>Cardiolipin-IgM;P&nbsp;&lt; 10 x 10<sup>3</sup>&nbsp;int.enh./L</li>
</ul>
<h2>NPU-koder og -navne</h2>
<ul>
    <li>NPU17553 P-Cardiolipin-antistof;arb.stofk.(liste);P, best&aring;r af:
    <ul>
        <li>NPU12020&nbsp;</li>
        <li>NPU12021&nbsp;</li>
    </ul>
    </li>
</ul>
<h3>Navne</h3>
<ul>
    <li><strong>Langt navn</strong>
    <ul>
        <li>P&mdash;Cardiolipin-antistof; arb.stofk.(liste; proc.)</li>
        <li>P&mdash;Cardiolipin-antistof(IgG); arb.stofk.(proc.) = ? (p.d.e.)</li>
        <li>P&mdash;Cardiolipin-antistof(IgM); arb.stofk.(proc.) = ? (p.d.e.)</li>
    </ul>
    </li>
    <li><strong>Kort navn</strong>
    <ul>
        <li>Cardiolipin-Ab gruppe;P</li>
        <li>Cardiolipin-IgG;P</li>
        <li>Cardiolipin-IgM;P</li>
    </ul>
    </li>
</ul>
<ul>
</ul>
<h2>Opf&oslash;lgning ved positivt fund&nbsp;<a href="EditorPage.aspx?da=core&amp;id=%7BEBCCED0F-591D-4F9F-86A9-BD27C20D60FE%7D&amp;ed=FIELD8091163953&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H8091165547&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Garcia D, Erkan D, Diagnosis and Management of the Antiphospholipid Syndrome. N Engl J Med 2018;378: 2010-2021" data-value-piped="Garcia D, Erkan D|Diagnosis and Management of the Antiphospholipid Syndrome.|N Engl J Med|2018|378|2010-2021|29791828" data-url="reference-link" data-pubmedid="29791828" title="Garcia D, Erkan D, Diagnosis and Management of the Antiphospholipid Syndrome. N Engl J Med 2018;378: 2010-2021">5</a></h2>
<ul>
    <li>Analysen b&oslash;r gentages med yderlig to bestemmelser med 6-12 ugers mellemrum, f&oslash;r diagnosen APS stilles&nbsp;<a href="EditorPage.aspx?da=core&amp;id=%7BEBCCED0F-591D-4F9F-86A9-BD27C20D60FE%7D&amp;ed=FIELD8091163953&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H8091166750&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RH, DE Groot PG, Koike T, Meroni PL, Reber G, Shoenfeld Y, Tincani A, Vlachoyiannopoulos PG, Krilis SA, International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4: 295-306" data-value-piped="Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RH, DE Groot PG, Koike T, Meroni PL, Reber G, Shoenfeld Y, Tincani A, Vlachoyiannopoulos PG, Krilis SA|International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS).|J Thromb Haemost|2006|4|295-306|16420554" data-url="reference-link" data-pubmedid="16420554" title="Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RH, DE Groot PG, Koike T, Meroni PL, Reber G, Shoenfeld Y, Tincani A, Vlachoyiannopoulos PG, Krilis SA, International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006;4: 295-306">6</a> </li>
    <li>Analysen b&oslash;r suppleres med lupus antikoagulansunders&oslash;gelse </li>
    <li>Analysen b&oslash;r suppleres med &szlig;<sub>2</sub>-glykoprotein I antistoffer</li>
    <li>Analysen b&oslash;r suppleres med&nbsp;<a href="~/link.aspx?_id=0BD4B9011B64489E91B5EED6C33BD77E&amp;_z=z">APTT</a></li>
</ul>]]></HtmlField>
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