Abstract
Background:
The presence of antiphospholipid antibodies (aPLs) is associated with the clinical features of antiphospholipid syndrome (APS), which comprises venous and arterial thrombosis and pregnancy loss, and systemic lupus erythematosus (SLE). The prevalence of aPLs has been reported to be different in patient populations affected by either of these conditions. We performed a retrospective study to evaluate the prevalence and clinical associations of aPLs, including lupus anticoagulant (LAC), anticardiolipin (aCL), and anti-beta2-glycoprotein I antibodies (anti-beta2-GPI) in a cohort of Korean patients with SLE.
Methods:
This study included samples from 88 SLE patients for whom aPL testing had been advised between June 2006 and July 2009 at the Dong-A University Hospital. Serum and plasma samples were tested for LAC, aCL (IgG, IgM), and anti-beta2-GPI (IgG, IgM) antibodies. Clinical data from patients were obtained from a review of medical records.
Results:
LAC was the most common (34.1% of total patients, 30/88) antibody, followed by IgM aCL (31.8%, 28/88), IgG aCL (18.2%, 16/88), and IgM and IgG anti-beta2-GPI (both 5.7%, 5/88 each). Positivity for LAC was strongly associated with venous/arterial thrombosis (P=0.002).
Conclusions:
LAC was the most common antibody detected in Korean SLE patients and is shown to have a significant association with the presence of venous/arterial thrombosis. The measurement of LAC may be clinically useful in identifying patients with SLE who are at a high risk for venous/arterial thrombosis.
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Table 1.
Variable | No APS (N=82) | APS (N=6) |
---|---|---|
Sex (Female/male) | 74/8 | 5/1 |
Median age (range) | 32 (17-62) | 30.5 (27-35) |
Clinical manifestation∗ | ||
Arterial/venous thrombosis | 0 (0.0) | 6 (100.0) |
Pregnancy loss† | 2 (2.7) | 1 (20.0) |
Thrombocytopenia | 9 (11.0) | 2 (33.3) |
Medication∗ | ||
Corticosteroids | 82 (100.0) | 6 (100.0) |
Hydroxichloroquine | 43 (52.4) | 4 (66.7) |
Azathioprine | 15 (18.3) | 0 (0.0) |
NSAIDs | 32 (37.8) | 2 (33.3) |
Mycophenolate mofetil | 9 (11.0) | 1 (16.7) |
Methotrexate | 10 (12.2) | 0 (0.0) |
Table 2.
LAC | aCL∗ | anti-beta2-GPI∗ | N (%) | ||
---|---|---|---|---|---|
No APS (N=82) | APS (N=6) | Total (N=88) | |||
+ | + | + | 4 (4.9) | 0 | 4 (4.5) |
+ | + | - | 11 (13.4) | 1 (16.7) | 12 (13.6) |
+ | - | + | 0 | 0 | 0 |
+ | - | - | 9 (11.0) | 5 (83.3) | 14 (15.9) |
- | + | + | 3 (3.7) | 0 | 3 (3.4) |
- | + | - | 15 (18.3) | 0 | 15 (17.0) |
- | - | + | 1 (1.2) | 0 | 1 (1.1) |
- | - | - | 39 (47.6) | 0 | 39 (44.3) |
Table 3.
Table 4.
Arterial/venous thrombosis | Pregnancy loss∗ | Thrombocytopenia | |||||||
---|---|---|---|---|---|---|---|---|---|
Yes (N=6) | No (N=82) | P | Yes (N=3) | No (N=76) | P | Yes (N=11) | No (N=77) | P | |
LAC+ (N=30) | 6 | 24 | 0.002 | 1 | 23 | 0.67 | 7 | 23 | 0.12 |
IgG aCL+ (N=16) | 1 | 15 | 0.65 | 0 | 14 | 0.94 | 4 | 12 | 0.21 |
IgM aCL+ (N=28) | 0 | 28 | 0.20 | 0 | 23 | 0.56 | 5 | 23 | 0.48 |
IgG anti beta2-GPI+ | 0 | 5 | 0.77 | 0 | 5 | 0.40 | 1 | 4 | 0.86 |
(N=5) | |||||||||
IgM anti beta2-GPI+ (N=5) | 0 | 5 | 0.77 | 0 | 5 | 0.40 | 1 | 4 | 0.86 |