I’m Looking For Input Interpreting A Blood Test

Posted on Sun, 31 Mar 2019

Question: I’m looking for input interpreting a blood test

Answered by Dr. Monish De (9 hours later)

Brief Answer:

Antiphospholipid antibody syndrome (APS)

Detailed Answer:

Hi

I have gone through your reports

CARDIOLIPIN AND PHOSPHATIDYL panel test is done to see antiphospholipid antibody syndrome (APS) which is an is an autoimmune disorder.

Antiphospholipid syndrome can cause blood clots to form within the arteries, veins and organs.

It can also cause miscarriage and stillbirth in pregnant women.

All your tests are normal except little bit elevated Antiphosphatidylserine IgM

It is mildly elevated.

If you are not having symptoms such as blood clots in your legs (DVT) and pain, swelling and redness there is nothing to worry

Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Monish De (6 hours later)

I have no current blood clots but did have bilateral clots in lungs diagnosed in August. I had been on birth control pills for 2 years at that time.
I have been on Xarelto for 6 months and want stop Xarelto so that can resume normal sports activity. I had a CT in feb that confirm no clots.
Is the igM level of 30 elevated enough to ay I should stay in Xarelto forever. Or does it need to be over 35 or 40 to confirm APS?
How much weight do we give to birth control pills being a major contributor to the PE.
That is my first instance of any clotting.

Answered by Dr. Monish De (54 minutes later)

Brief Answer:

A diagnosis of APS can only be made after 2 abnormal blood test

Detailed Answer:

Hi

A diagnosis of APS can only be made after 2 abnormal blood test results with at least a 12 week gap between them.

This is because harmless antiphospholipid antibodies can sometimes develop in the body for short periods of time.

As antiphospholipid antibodies has been identified during the first blood test i will advise you another test at a later date to confirm whether the abnormal antibodies are still present.

Birth control pills that contain the hormone drospirenone are linked to a higher risk of PE.

However pulmonary embolism caused by birth control pills is a rare side effect, but your individual risk could be higher because of other factors

After the second blood test whether Xarelto can be stopped can be decided

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Monish De (2 hours later)

Ok. Just one final question

Would a second result of even slightly elevated igM of 30 still diagnose APS?

Is 30 or less a second time still a definitive APS diagnosis. Or does it need to be higher

Answered by Dr. Monish De (5 minutes later)

Brief Answer:

If second time comes out elevated igM of 30

Detailed Answer:

Hi

If second time comes out elevated igM of 30 or more that means you are having APS

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Monish De (54 minutes later)

Thanks.

Would that be considered low level APS?

Since only one incident of PE, contributed by birth control pills, would no treatment be acceptable to see if they recur?

Is blood thinners such as Xarelto the only treatment. Does aspirin have any benefit

Continuing to play college soccer is an important objective, balancing it with staying safe obviously.

Answered by Dr. Monish De (13 hours later)

Brief Answer:

Low level APS is phosphatidylserine Antibody IgM more than 25 U/mL

Detailed Answer:

Hi

Low level APS is phosphatidylserine Antibody IgM more than 25 U/mL

The main treatment for APS is anticoagulant therapy.

Rivaroxaban sold under the brand name Xarelto among others, is an anticoagulant medication used to treat and prevent blood clots.

XARELTO in combination with low-dose aspirin (75 mg–100 mg), is now approved for treatment of APS

Aspirin is recommended for primary prevention in individuals who have APL

Regards

Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Nagamani Ng