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Clinical Approach to Antiphospholipid Antibodies
by Steven R. Levin and Robin L. Brey, 147 pp, with illus, $59.95,
Woburn, Mass, Butterworth-Heinemann, 2000.
Arch Neurol. 2002;59:650-651.
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This well-structured overview of literature concerning molecular characteristics
and clinical consequences of antiphospholipid (APL) antibodies reflects a
recent, exponential development of an interdisciplinary field that began with
scattered observations in the early 20th century. Chronological descriptions
of discoveries are incorporated into relevant chapters on basic science and
clinical studies, and explain the historical and immunological relationships
between anticardiolipin antibodies and lupus anticoagulant, now both included
in the large group of APL antibodies. The review of data reveals the complexity
of the subject because of the heterogeneity of APL antibodies, with increasingly
recognized diversity in antigenic specificities and in possible effector mechanisms,
which often lead to multiple and interrelated clinicopathological events.
The mechanism of production and pathogenic significance of APL immunoglobulins
also varies. Antiphospholipid antibodies of the immunoglobulin (Ig) G isotype
can arise by a primary mechanism and be associated with antiphospholipid syndrome
(APS), presenting with recurrent arterial or venous thrombosis . . . [Full Text of this Article]
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