Antiphospholipid
antibodies in systemic lupus erythematosus patients
Fojtík Z.1, Beránek M.2, Kořístek Z.1, Klabusay M.1, Buliková A.3
1Interní hematoonkologická klinika, Fakultní nemocnice Brno Bohunice, 2Centrum biostatistiky a analýz Lékařské a Přírodovědecké fakulty MU, 3Oddělení klinické hematologie, Brno |
|
Summary:
Different levels of coagulation cascade may be variously altered by antiphospholipid antibodies
(APA). The aPL may cause different clinical symptoms, typically thrombosis, recurrent miscarriages
and thrombocytopenia. Aim: to analyse retrospectively occurrence of lupus anticoagulant (LA) and
APA (mixture of phospholipids – cardiolipin, phosphatidic acid and phosphatidylserin in the
commercial set) in systemic lupus erythematosus (SLE) patients and to correlate these parameters
with the history of thrombotic events. Material and methods: A group of 46 patients who fulfilled
ACR criteria for SLE was evaluated. Nonspecific parameters of inflammation, autoantibodies (ANA,
anti-ENA, anti-dsDNA,anti-Ro, anti-La, anti-Sm, anti-snRNP),lupus anticoagulant andantiphospholipid
antibodies – cardiolipin, phosphatidic acid and phosphatidylserin in commercial set (APA test)
were followed. A history of thrombotic events was evaluated. Results: In this group there were 13
LA positive, 33 LA negative, 18 APA positive, and 28 APA negative patients. Forty thrombotic events
were detected. Venous thrombosis was detected in 62% in a group of LA positive and in 18% in LA
negative patients (p<0.05). Arterial thrombosis has occurred in 31% and 6% in LA positive and LA
negative groups respectively (p<0.05). No statistical significance was detected with respect to
incidence of spontaneous abortions. Similar results were found inAPApositive andnegative groups;,
for venous (p<0.05) and arterial thrombosis (p<0.05) and for miscarriages. Thrombocytopenia below
100x109/l was detected in 31% and 6% of LA positive and LA negative groups respectively (p<0.05).
Statistical significance was detected in the ANA titres >1:160 and in anti-ENA autoantibodies
presence. Eight per cent of such patients were found in a LA+ group and 58% in LA- group (p<0.05).
Secondary antiphospholipid antibody syndrome was found in 30% of SLE patients, 79% of LA
positive, and 93% of APA positive group. Discussion: this retrospective analysis demonstrates
statistically significant correlation between LA and APA positivity and history of thrombotic events.
The correlation was associated with venous and arterial thrombosis and thrombocytopenia. It is
also evident that thrombophilia observed in SLE may be caused by variety of antiphospholipid
antibodies and other factors.
Key words:
|