How do you approach anticoagulation in a woman with SLE who is planning pregnancy, has persistently positive isolated anticardiolipin IgA and anti-β2 glycoprotein I IgA antibodies and a prior history of a provoked DVT after prolonged air travel?

Such a patient with IgA isotype APL antibodies would not meet EULAR – ACR classification criteria for antiphospholipid syndrome. However, there is evidence that IgA anti-Beta 2GP1 can be pathogenic. Therefore, this patient can meet less stringent disease classification and be considered a candidate ...

I consider persistently positive IgA anticardiolipin and anti-β2 glycoprotein antibodies just as relevant as IgG/IgM subclasses. Moreover, phosphatidylserine antibodies are also relevant, if this patient could be tested for that as well.