IgM Antiphospholipid Antibodies in Antiphospholipid Syndrome : Prevalence, Clinical Associations, and Diagnostic Implications-A Scoping Review
Ockova, Monika (Vall d'Hebron Institut de Recerca (VHIR))
Anunciación-Llunell, Ariadna (Vall d'Hebron Institut de Recerca (VHIR))
Andrada, Catalina (Vall d'Hebron Institut de Recerca (VHIR))
Esteve-Valverde, Enrique (Hospital Sant Camil (Barcelona))
Miró-Mur, Francesc (Vall d'Hebron Institut de Recerca (VHIR))
Alijotas-Reig, Jaume (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2025
Resum:	Background : IgM antiphospholipid antibodies (aPL) were de-emphasised in the 2023 ACR/EULAR criteria, yet their precise clinical significance remains uncertain. Methods : A rapid scoping review of PubMed (January 2000-June 2025) identified original human studies reporting IgM aCL, aβGPI, or aPS/PT prevalence or outcomes; 40 studies met the eligibility criteria. Prevalence and odds ratios (ORs) of clinical associations were extracted. Results : IgM aPL are common across APS phenotypes. Obstetric cohorts showed aCL-IgM prevalences of 3-82%, often equal to or exceeding those of IgG, while aβGPI-IgM reached a prevalence of 2-63%. In mixed thrombotic-obstetric cohorts, aPS/PT-IgM was the most frequent isotype (31-79%). Purely thrombotic studies still reported 0-59% aβGPI-IgM, with PS/PT-IgM at 55% and 62% in two large series. Significant outcome signals from clinical associations of IgM aPL were inconsistent but noteworthy in (i) pregnancy loss for high-titre aCL, aβGPI, and aPS/PT, (ii) thrombosis driven by aPS/PT and (iii) organ-specific arterial events (retinal thrombosis and stroke) in isolated IgM phenotypes. Conclusions : The role of aPL-IgM remains uncertain. The findings advocate for a nuanced approach to IgM interpretation, supporting its reconsideration in specific clinical settings and emphasising the significance of ongoing research into the mechanistic and prognostic utility of IgM aPL.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Antiphospholipid syndrome ; Antiphospholipid antibodies ; Diagnosis ; Prevalence ; Obstetric manifestations ; Thrombotic manifestations ; non-criteria aPL
Publicat a:	Journal of clinical medicine, Vol. 14 (october 2025) , ISSN 2077-0383

DOI: 10.3390/jcm14207164
PMID: 41156037

22 p, 1.5 MB

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