Validation of the Sapporo criteria for antiphospholipid syndrome

Arthritis Rheum. 2000 Feb;43(2):440-3. doi: 10.1002/1529-0131(200002)43:2<440::AID-ANR26>3.0.CO;2-N.


Objective: To test the Sapporo criteria for the classification of the antiphospholipid syndrome (APS).

Methods: We classified 243 consecutive patients who had clinical diagnoses of primary APS (n = 49), secondary APS (n = 26), systemic lupus erythematosus (SLE) without clinical APS (n = 131), and lupus-like disease without clinical APS (n = 37).

Results: Sensitivity, specificity, positive predictive value, and negative predictive value were 0.71, 0.98, 0.95, and 0.88, respectively. False-negative findings were the result of patients being classified on the basis of minor criteria that were not included in the Sapporo criteria, such as livedo reticularis, thrombocytopenia, low-titer IgG or IgM anticardiolipin antibody, IgA anticardiolipin antibody, and anti-beta2-glycoprotein I antibody. Some patients with false-negative results were true seronegative cases.

Conclusion: The Sapporo criteria for APS compare favorably with the American College of Rheumatology criteria for SLE and are usable for clinical studies.

MeSH terms

  • Adult
  • Antibodies / blood
  • Antibodies, Anticardiolipin / blood
  • Antiphospholipid Syndrome / blood
  • Antiphospholipid Syndrome / classification*
  • False Negative Reactions
  • Female
  • Glycoproteins / immunology
  • Humans
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / diagnosis
  • Male
  • Middle Aged
  • Pregnancy
  • Reproducibility of Results
  • Skin Diseases, Vascular / diagnosis
  • Thrombocytopenia / diagnosis
  • beta 2-Glycoprotein I


  • Antibodies
  • Antibodies, Anticardiolipin
  • Glycoproteins
  • beta 2-Glycoprotein I