Do you send an antiphospholipid antibody panel routinely for all patients with an unprovoked thrombus?

Yes. My own practice is to perform testing for antiphospholipid antibodies in all patients with unprovoked VTE and also in patients with arterial thrombosis. Testing should include assays for lupus anticoagulant, anti-cardiolipin antibodies (IgG and IgM), and anti-beta 2 glycoprotein I antibodies (IgG and IgM). The role of testing for IgA antibodies and PS/PT antibodies is evolving. The rationale is that triple positive patients have a lower risk of recurrent thrombosis with warfarin rather than...

I test for antiphospholipid antibodies for all unprovoked thrombosis for the following reasons. If the thrombosis is associated with antiphospholipid antibodies, the treatment should be continued as long as the antibodies persist (which may be a long time). Secondly, warfarin may be superior to direct acting anticoagulants in certain situations.

We would test for anticardiolipin and anti β2-glycoprotein I antibodies by ELISA and for lupus anticoagulant [PTT-LA and DRVVT (screen and confirm)].