Prevalence Of Anticardiolipin Antibodies Research Articles

The Interaction of Sickle Cell Trait and Anticardiolipin Antibodies in Venousthromboembolism

IntroductionAmong the risk factors for venous thromboembolism (VTE) are inheritance of the sickle cell gene and antiphospholipid syndrome. Antiphospholipid antibodies are elevated in sickle cell disease but there is little information on its levels in sickle cell trait. The prevalence of anticardiolipin antibodies and association with VTE is equally not known in the Nigerian population.MethodsA case control study involving 50 consecutive patients with Doppler confirmed venous thromboembolism at the University College Hospital Ibadan and 50 apparently healthy individuals. Haemoglobin electrophoresis was carried out using cellulose acetate membrane. IgG and IgM anticardiolipin antibodies were assayed by ELISA.ResultsThe mean age of the patients was 58.7±18.5years, range of 21-89 years, there were 21 males (42%). Majority of the patients (42 (84%)) had deep venous thrombosis while five (10%) patients presented with pulmonary embolism, one had both deep venous thrombosis and pulmonary embolism. A patient had portal vein thrombosis and another, an intracardiac clot. Sedentary lifestyles, hypertension and concomitant malignancy were the most prevalent risk factors (34% each) (figure I). Both sedentary lifestyle and cancer were significantly associated with VTE (p<0.001). Sickle cell trait (Hb AS) occurred in the same number of patients and controls (eleven each). Higher levels of both IgG and IgM anticardiolipin antibodies were found among the VTE patients with sickle cell trait than controls. (Table 1) The mean levels of IgG antibody in Hb AS patients was 31.7 ± 12.8 GPL compared to 25 ± 13.8 GPL in the controls (p= 0.254) and mean IgM anticardiolipin antibodies in Hb AS patients was 18.7 ± 6.2 GPL while that of the controls was 16.8 ± 11.6 GPL (p= 0.633). The global mean levels of IgG and IgM anticardiolipin antibodies in the patients with VTE were 29.7 ± 9.1 GPL and 24.8 ±16.7 GPL respectively versus 28.5 ±13.7 GPL and 25.2 ±16.2 GPL in the controls. A multivariable logistic regression showed age, sedentary lifestyle and anemia as independent risk factors while a positive IgM anticardiolipin antibody appeared protective for VTE. (Table 2)ConclusionThe prevalence of sickle cell trait and anticardiolipin levels did not differ between VTE patients and healthy controls. Age, hypertension, sedentary lifestyle and malignancies were identified risk factors in our cohort of patients. Larger prospective studies may be helpful in determining the influence of sickle cell trait and antiphospholipid antibodies in venous thromboembolism. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Study on Anticardiolipin Antibodies in Women With Recurrent Abortion in Duhok Province, Kurdistan Region, Iraq

Recurrent abortion is a worldwide issue. Anticardiolipin antibodies (ACA) are found to be among the most important factors related to recurrent spontaneous early pregnancy loss. This study aimed to investigate the prevalence of anticardiolipin IgM and IgG antibodies in women with recurrent abortion in Kurdistan Region of Iraq. The present study was conducted in Duhok and Zakho cities for the period from April 2014 to May 2019. A total of 1230 women aged between 18 to 46-year-old were included in this study. ELISA was used for the detection of anticardiolipin antibodies. Among the studied subjects, the prevalence of anticardiolipin antibodies was 74 (6.02%) for ACA IgM and 56 (4.6%) for ACA IgG. It was also observed that 16 (1.3%) subjects were positive for both ACA IgM and IgG antibodies. Additionally, the highest anticardiolipin antibody positivity rates were recorded in patients older than 30-year-old (P&lt;0.01). The IgM ACA positivity was higher in Zakho city 45 (7.2%) when compared to Duhok city 29 (4.6%) (P&lt;0.04). In conclusion, anticardiolipin antibodies can have a positive association among women with recurrent abortion. Therefore, it is suggested that women with recurrent abortion should be screened for anticardiolipin antibodies; this could increase fetal survival by initiating early anticoagulant therapy when other causes of abortion are excluded.

Risk of vascular access thrombosis in patients with systemic lupus erythematosus on hemodialysis.

Anticardiolipin antibody is associated with increased risk of vascular access thrombosis (VAT) in hemodialysis (HD) patients. Systemic lupus erythematous (SLE) patients have a high prevalence of anticardiolipin antibodies, but it is not clear whether these patients are at high risk of developing vascular access thrombosis. Thirty six SLE patients on HD, who had either an arterio-venous (AV) graft or AV fistula as vascular access, and were not on anticoagulation treatment, were retrospectively identified at Henry Ford Hospital. A similar number of patients without SLE, matched for age, sex, race and type of vascular access were selected as a control population. Vascular access thrombosis rate at one year was compared between two groups. Mean age at dialysis was 36+/-10 years in 36 SLE patients (28 females, 8 males) and was 38+/-6.4 years in 36 non-SLE patients (29 females, 7 males). Of all patients, 29/36 (80.5%) SLE and 27/36 (75%) non-SLE patients had AV grafts, whereas the rest had AV fistulas as vascular access (19.5% SLE and 25% non-SLE patients). Out of 36 SLE patients, 24 (66.6%) patients developed VAT at one year as compared to 14 (38.9%) patients in non-SLE group (p<0.05). The odds ratio of VAT in SLE patients was 3.1 (95% CI 1.2-8.2). SLE patients on hemodialysis are more likely to develop vascular access thrombosis as compared to non-SLE patients.

The Prevalence of Anticardiolipin Antibodies in women with Bad Obstetric History

Background: Bad obstetric history (BOH) implies previous unfavorable fetal outcome in terms of two or more consecutive spontaneous abortions, early neonatal deaths, stillbirths, intrauterine fetal deaths, intrauterine growth retardation and congenital anomalies. The immune factors associated with pregnancy loss are classified as autoimmune and alloimmune factors. The autoimmune factors include the synthesis of autoantibodies (anti-phospholipid antibodies, anti-nuclear antibodies, anti-thyroid antibodies). The main types of antiphospholipid antibodies are Lupus Anticoagulant (LA) and Anticardiolipin (aCL) antibodies (IgG &amp; IgM).Objective: To measure the level of anticardiolipin antibodies in the sera of women with bad obstetric history.Patients &amp; method: the study was conducted from October 2009 till June 2011 including 117 patients who attended private clinic &amp; laboratory. Patients included in the sudy were those with history of two or more recurrent miscarriages, intrauterine fetal death &amp; stillbirth. Fetal losses due to diabetes or congenital anomalies were excluded.Serum levels of anticardiolipin IgM &amp; IgG antibodies were measured using AESKULISA phospholipid-Screen-GM (Germany) which is a solid phase enzyme immunassay for the separate qualitative &amp; quantitative detection of IgG and /or IgM antibodies in human sera.Results: from the total of 117 patients with BOH fourteen (11.96%) had positive anticardiolipin antibodies in their sera. When comparing between the different groups of patient who were classified according to the type of fetal loss the highest number &amp; percentage of positive anticardiolipin antibody were found in those with three &amp; more recurrent miscarriages (4 cases, 57.14%). When comparing the IgM &amp; IgG levels in different patients groups, the highest levels were found in those with three &amp; more recurrent miscarriages.Conclusion: Anticardiolipin antibodies can have a positive association in women with bad obstetric history especially those with three &amp; more recurrent miscarrigages. The level of IgM &amp; IgG is highest in this group however these antibodies should be looked for in other patients with BOH

Anticardiolipin antibody in egyptian patients with chronic hepatitis c in correlation with liver injury

Background The presence of anticardiolipin (ACL) antibodies in chronic hepatitis C may be owing to induction of neoantigens by chronic viral infection, which may be because of disruption of liver cell membranes. The occurrence of these ACL antibodies may be observed because of recognition of these neoantigens by the immune system. Aim The aim of the work was to study the prevalence and clinical significance of ACL antibodies in chronic hepatitis C infection and their relationship with disease progression. Participants and methods Our study was performed on 90 individuals recruited from Gastroenterology and Hepatology Outpatient Clinics and Internal Medicine Department of Kafr Sheikh Institute. The participants were divided into the following three groups: group A consisted of 30 patients with chronic hepatitis C virus (HCV) infection with compensated liver cirrhosis, group B consisted of 30 patients with chronic HCV infection with decompensated liver cirrhosis, and group C consists of 30 individuals as control. All patients and control were subjected to full history taking, full clinical examination, complete blood count, liver function tests, renal profile, pelvis–abdominal ultrasound, and serum levels of ACL immunoglobulin G and α-fetoprotein. Results The results showed that seven (23%) of the HCV-positive patients in group A and 18 (60%) of the HCV-positive patients in group B were ACL immunoglobulin G-positive in comparison with none in the control group (0%). Conclusion The prevalence of ACL antibodies is increased during HCV infection, and HCV should be regarded as a possible causative factor in the antiphospholipid syndrome.

Prevalence of Anti-Cardiolipin and Anti-β2 Glycoprotein Antibodies in Indian Systemic Lupus Erythematosus Patients

Anti-phospholipid antibodies (APA) like anti-cardiolipin antibodies (ACA) and anti-β2glycoprotien (anti-β2GP) are important cause of venous and arterial thrombosis and other occlusive vascular diseases. The prevalence of these antibodies in SLE patients at the time of diagnosis is not known in Indian SLE patients. This study was conducted to evaluate the prevalence of ACA and anti-β2GP autoantibodies in SLE patients and to correlate them with disease activity and immune parameters such as C3, C4 and CRP levels. where 85 SLE patients referred from Rheumatology Department, KEM hospital, Mumbai were studied. SLE disease activity was evaluated by SLE Disease Activity Index (SLEDAI) score at the time of evaluation. All patients studied were in an active stage of disease of which 37.6% patients had renal disorders, which were categorized as Lupus Nephritis (LN) and 62.3% patients did not show any renal manifestations (non-LN). ACA and anti-β2GP autoantibodies, to IgG and IgM subclasses were tested by ELISA. C3, C4 and CRP levels were detected by nephelometer. It was observed that 12.9% patients were IgG-ACA and IgM-ACA positive and ACA positivity was noted more among LN group Anti-β2GP autoantibody positivity was 27.1% for IgG and 31.8% for IgM., IgG-anti-β2GP antibodies were slightly higher in non-LN patients, whereas a higher incidence of IgM-anti-β2GP antibodies were detected in LN patients. Hence detection both ACA and anti-β2GP antibodies along with associated immune parameters were helpful to evaluate their possible association with disease severity in SLE patients. A long term follow up of patients having ACA and anti-β2GP antibodies without thrombotic event is also needed to detect their possible thrombotic event in future along with their clinical presentation.

Anaesthetic implications of a parturient with antiphospholipid antibody syndrome

Antiphospholipid antibody syndrome (APS) is an acquired autoimmune disorder characterised by venous and/or arterial thromboses. When present in women of reproductive age, it is associated with recurrent loss of pregnancy. Antiphospholipid antibodies are directed against various phospholipids in the body, and include anticardiolipin antibodies and the antibodies responsible for the lupus anticoagulant. 1 The prevalence of anticardiolipin antibodies has been reported to be between 2.7 and 7% in the general obstetric population. 2–4 For many years, an association between circulating maternal antiphospholipid antibodies and recurrent pregnancy loss has been acknowledged. 2–4 Pregnancy loss is thought to be caused by thrombosis of placental vessels. Various interventions have been recommended to assist in the maintenance of the pregnancy until delivery of a live infant. The mainstay of treatment has included low-dose aspirin, either alone or combined with unfractionated heparin (UH) or low-molecular-weight heparin (LMWH). 5 However, this anticoagulation predisposes the patient to haemorrhage, and may be a contraindication to regional anaesthesia. Here, we highlight a case of a parturient with APS and discuss the anaesthetic implications.

Thyroid Autoimmunity and its Association with Cellular and Humoral Immunity in Women with Reproductive Failures

thyroid autoimmunity (TAI), which is T helper (Th)1-cell-mediated autoimmunity to thyrocytes, is associated with increased risk of miscarriages and highly prevalent in women with infertility. We aim at investigating the prevalence of TAI in women with recurrent spontaneous abortions (RSA) or unexplained infertility (UI) and its relationship with cellular and humoral immune abnormalities. prevalence of antiphospholipid antibodies, anti-nuclear antibody, other non-organ-specific antibodies (NOSAs; anti-dsDNA, anti-ssDNA, anti-histone, anti-Scl70), peripheral blood natural killer (NK) cell levels (%) and cytotoxicity, and CD3(+) /CD4(+) Th1/Th2 cell ratios were compared in women with and without TAI. Thyroid functional tests (TFT) were analyzed in both groups before and after pregnancy. tumor necrosis factor-α/IL-10 expressing CD3(+) /CD4(+) cell ratios (P < 0.05), CD56(+) NK cell levels (P < 0.05), the prevalence of anticardiolipin antibodies (P < 0.05) and other NOSAs (P < 0.005) were significantly higher in women with TAI when compared to women without TAI. Changes in thyroid-stimulating hormone levels between before and after pregnancy in women with TAI were significantly higher when compared to those of women without TAI (P < 0.05). TAI is associated with impaired cellular and humoral immune responses in women with RSA or UI. In women with TAI, serial TFT is recommended when pregnancy is established.

Contagem de plaquetas e caracterização clínica de úlceras de perna anticardiolipinas positivas

To study the prevalence of anticardiolipin antibodies in patients with venous, diabetic and arterial leg ulcers and to verify if platelet count, previous history of venous thrombosis, obstetrical history and the finding of livedo reticularis are markers of this autoantibody positivity. 151 patients with leg ulcer (81 with venous, 50 with diabetic and 20 with arterial ulcers) and 150 controls were included. In both groups search for the presence of IgG and IgM anticardiolipin and platelet count was done. In the leg ulcer group demographic data, obstetrical history, previous history of venous thrombosis as well as presence of livedo reticularis by physical examination were pointed out. Data was grouped in contingency and frequency tables and the tests of Fisher and chi-squared were used for nominal variables and Mann Whitney and Kruskall Wallis for numerical variables. The adopted significance was of 5%. It was found an anticardiolipin prevalence of 7.2% (n=12) in the leg ulcer group and of 1.3% (n=2) in the control group (p=0.01). Leg ulcer patients with anticardiolipin did not differ from those without it in gender (p=0.98), previous history of venous thrombosis (p=0.69), previous history of abortions (p=0.67) and platelet count (p=0.67). Only two patients had livedo reticularis which precluded any conclusion on this data. There is an increased prevalence of anticardiolipin antibodies in the general population with leg ulcers. Clinical characteristics of ulcers as well as platelet count do not help in the identification of these patients.

Anticorpos anticardiolipinas em úlceras de perna

To verify the prevalence of IgG and IgM anticardiolipin antibodies in patients with leg ulcer (venous, arterial and diabetic) and if these patients can be identified by clinical means. A series of 151 patients with leg ulcer (81 venous, 50 diabetic and 20 arterial ulcers) and 150 controls were studied. In both groups it was searched the presence of IgG and IgM anticardiolipin by the ELISA method. In the leg ulcer group demographic data were obtained, data on the leg ulcer size and number as well as pain severity measured by an analogical visual scale. In statistic analysis, the adopted significance was of 5%. It was found an anticardiolipin prevalence of 7.2% (n=12) in the leg ulcers group and of 1.3% (n=2) in the control group (p=0.01). Comparing the different ulcer types with control population, it was found that there was an increase in anticardiolipin antibodies in venous (p=0.02), and diabetic (p=0.01) but not in arterial ulcers (p=0.31). Leg ulcer patients with anticardiolipin did not differ from those without it in gender (p=0.98); ulcer size (p=0.6); pain severity (p=0.67), mean number of ulcers (p=0.38), mean disease duration time (p= 0.59) and previous history of venous thrombosis (p=0.69). There is an increased prevalence of anticardiolipin antibodies in patients with venous leg ulcers and diabetic ulcers but not in those of arterial origin. Clinical characteristics of ulcers do not help in the identification of these patients.

Péricardites lupiques : prévalence, caractéristiques cliniques et immunologiques

Our study sought to determine the frequency and clinical and immunologic characteristics of pericarditis in patients with systemic lupus erythematosus (SLE). We retrospectively analyzed the files of all patients with SLE diagnosed between 1987 and 2005. The study included only those patients who had undergone echocardiography. They were divided in two groups according to whether or not they had pericarditis, and their clinical and immunologic characteristics and outcome were compared. Our records found 180 patients with SLE, 97 of whom had had echocardiography. The frequency of pericarditis was 39%. The average age of the 34 women and 4 men with pericarditis at its onset was 36.4 years. There were 59 SLE patients without pericarditis, 56 women and 3 men with an average age of 28.8 years. Pericarditis was frequently associated with pleural effusions. The prevalence of anticardiolipin antibodies was significantly lower in the group of patients with pericarditis. Pericarditis is the most common cardiac manifestation in SLE. Its frequency in this sample of Tunisian patients was similar to that described in different ethnic groups. The association between pericarditis and pleuritis is standard. Anticardiolipin antibodies, commonly positive in valve diseases, were less frequent in our patients with pericarditis.

Antiphospholipid antibodies and hepatitis C virus infection in Iranian thalassemia major patients

Although the precise nature of Antiphospholipid antibodies is still not clearly defined, they are known to have association with thromboembolic events and have been found in hepatitis C virus (HCV) infection. Moreover, high prevalence of HCV infection and thrombotic risk is described in thalassemia. We aimed at investigating the prevalence of anticardiolipin antibodies (aCLAbs), lupus anticoagulant (LA), and their relation with HCV infection in Iranian thalassemic patients. Presence of anti-HCV antibody, serum HCV-RNA, aCLAbs, and LA activity was determined in 131 patients with thalassemia major (male/female: 63/68 aged 3-29 years) registered at thalassemia unit, Dastgheib Hospital, Shiraz, Iran. Sixty-one healthy controls were also included. Anti-HCV antibody was positive in 24 (18.3%), IgG aCLAbs in 56 (42.7%), and LA activity in 9 (6.9%) patients. 87.5% of patients positive for aCLAbs had a low titer of aCLAbs. Although none of the participants had a previous history of thrombosis, higher prevalence of aCLAbs was detected in thalassemic patients compared with controls. No significant difference in the prevalence of aCLAbs was found between HCV-infected and noninfected patients. A high prevalence of aCLAbs, the majority in low titers, was detected in Iranian thalassemic patients irrespective of previous history of thrombosis and presence of HCV infection.

Prevalence of Anticardiolipin and Anti-β2-Glycoprotein I Antibodies in Celiac Disease

The aim of this study was to evaluate the prevalence of anticardiolipin antibodies (aCL) and anti-beta(2)-glycoprotein I antibodies (abeta2GPI) in patients with celiac disease and to analyze the clinical features of antiphospholipid syndrome in these patients. We conducted a prospective case-control study based on the evaluation of IgG, IgM and IgA aCL, and IgG and IgA abeta2GPI in celiac disease patients and in controls. All patients were asked about any occurrence of thrombotic manifestations. In addition, women were asked about pregnancy morbidity. Fifty celiac disease patients and 50 healthy controls were studied. IgM aCL were not detected in study group or in controls. IgG aCL were found in two patients and in one control. IgA aCL were significantly more frequent in celiac disease patients compared with controls (13/50 (26%) vs. 2/50 (4%), p=0.004, OR [95% CI]=9.09 [1.81-50]). There was no statistically significant difference for the prevalence of IgG and IgA abeta2GPI between patients and controls. Clinical features of antiphospholipid syndrome were noted in two patients with negative antibodies. Prevalence of IgM and IgG aCL and of abeta2GPI were not increased in celiac disease. IgA aCL were more frequently detected in celiac disease. However, no clinical features of antiphospholipid syndrome were noted.

Autoantibodies in Argentine Women with Recurrent Pregnancy Loss

To determine the presence or absence of subclinical autoimmunity in Caucasian Argentine healthy women with first trimester recurrent pregnancy loss (RPL), the sera of 118 healthy women with a history of three or more consecutive abortions and 125 fertile control women without abortions and two children were analyzed for the presence of autoantibodies: immunoglobulin (Ig)G and IgM anticardiolipin, antinuclear (ANA), antismooth muscle (ASMA), antimitocondrial (AMA), antiliver-kidney-microsomal fraction (LKM), antigastric parietal cells (GPC), antineutrophil cytoplasmatic (ANCA) and antibodies antigliadin type IgA and IgG and IgA antitransglutaminase related with celiac disease (CD). ANA, ASMA, AMA, anti-LKM, antibodies to GPC and ANCA were determined by indirect immunofluorescence (IFI) and anticardiolipin, antigliadina and antitransglutaminase antibodies were measured by enzyme-linked immunosorbent assays (ELISA). There was no significant difference between controls and patients with ANA, ASMA, AMA, LKM, ANCA and GPC. The prevalence of anticardiolipin antibodies in RPL was significantly higher than controls (P < 0,01) and the prevalence of positive antibodies for antigliadina type IgA and IgG and IgA antitransglutaminase in RPL was significantly higher than controls (P < 0.04). We show that Caucasian Argentine women with RPL showed significantly higher incidence of anticardiolipin antibodies than normal controls and finally we recommended the screening of IgA and IgG antigliadina and IgA antitransglutaminase antibodies in pregnancy, because of the high prevalence of subclinical CD in RPL and the chance of reversibility through consumption of a gluten free diet.

ANTIPHOSPHOLIPID SYNDROME IN A HUMAN IMMUNODEFICIENCY VIRUS 1-INFECTED CHILD

High prevalence of anticardiolipin antibodies and antiphospholipid antibodies has been reported in human immunodeficiency virus (HIV)-infected patients. A full blown clinical picture of antiphospholipid syndrome (APLS) is rare and rarely reported, even in HIV-infected adults and has never been reported in HIV-infected children. We report an HIV-infected child with left sided choreoathetosis associated with APLS.

Anticardiolipin antibodies in various diseases in Taiwan: a retrospective analysis.

The goals of this study are to determine the frequency of anticardiolipin antibodies (ACA) in patients with various diseases and to evaluate the clinical significance of ACA in Taiwan. We collected 690 patients from ACA laboratory records. They were divided into eight groups in order to compare ACA percentages. Positive rates of ACA in different disease groups were below 20%, except for 38.2% in autoimmune diseases with vascular thrombosis. Compared with old stroke, the ACA positivity in young stroke was not significantly different (P = 0.482). The positive percentage of lupus anticoagulant (LA) (2.86%) was lower than that of ACA (15.66%) in young stroke (P = 0.015). Among patients with pregnancy loss or prematurity, the ACA positivity in lupus patients (44.44%) was higher than without lupus (9.76%; P = 0.01). The prevalence of ACA is higher in patients with vascular thrombosis complicated by autoimmune diseases than with thrombosis alone in Taiwan. Young and old stroke do not differ in ACA positivity. Moreover, ACA is more prevalent than LA for young stroke related coagulation. The ACA positivity for pregnancy loss or prematurity is very low in Taiwan. In summary, this is the first report on the frequency of ACA and other coagulation factors in various diseases in Taiwan.

Antiphospholipid Antibodies in Patients with Lupus Nephritis

The aim of this study was to compare the prevalence of anticardiolipin antibodies with other types of antiphospholipid antibodies (aPL) (antiphosphatidylserine—aPS, antiphosphatidylinositol—aPI, antiphosphatidylethanolamine—aPE) in patients with lupus nephritis and to find if the examination of a panel of various aPL is valuable for further diagnosis of patients. Additionally we determined the levels of autoantibodies against β2-glycoprotein I (β2GPI) and oxidized low-density lipoprotein (anti-oxLDL) and also investigated the relationship between antibodies against β2GPI and oxLDL, which were assessed by ELISA methods. Twenty-two patients with lupus nephritis were studied. The control group consisted of 62 healthy blood donors. A statistically significant higher occurrence of all aPLs in the patients with lupus nephritis in comparison to the control group was found. The prevalence of polyspecific antibodies, which reacted with at least two various phospholipids, was 82% in the group of SLE patients. Significantly higher levels of IgG anti-β2GPI in the sera of SLE patients (p = 0.0003) was detected. The levels of anti-oxLDL in the sera of the patients group did not differ significantly from the control one. Some positive samples for anti-β2GPI and negative for aCL or anti-oxLDL and vice versa were found. It can be concluded that the production of aPL including anti-β2GPI and anti-oxLDL in the lupus nephritis patients is higher in comparison with healthy blood donors. We assume that the estimation of various types of aPL may be important in the selection of the group patients with renal diseases. The synthesis of aPL can reflect the spreading of the autoimmune response for several antigens modified on the vessel wall.

High prevalence of anticardiolipin antibodies in patients with HCV-associated oral lichen planus

Hepatitis C virus (HCV) has been linked to extrahepatic manifestations such as oral lichen planus (OLP). In addition, anticardiolipin antibodies (aCL) and cryoglobulin have been demonstrated in chronic hepatitis C. The aim of this study was to investigate these prevalences in patients with HCV-associated OLP. The prospective study investigated the role of these factors in 133 subjects: 28 with OLP-HCV(+) (group 1), 22 with OLP-HCV(-) (group 2), 33 without OLP-HCV(+) (group 3), and 50 healthy volunteers matched for age and sex served as control group (group 4). Levels of immunoglobulin G (IgG) and IgM aCL antibodies, and cryoglobulin in serum were evaluated by enzyme-linked immunosorbent assay. The prevalence of aCL in groups 1, 2, 3, and 4 were 32.1, 18, 36.3, and 8%, respectively. The positive rate of aCL was significantly higher in groups 1 and 3 than that in the control group (group 1; p=0.02 vs. the control group, group 3; p<0.01 vs. the control group). There were no significant differences in cryoglobulin among the groups. The findings of the present study showed a high prevalence of IgG and IgM aCL in the serum of patients with HCV infectious diseases. A positive factor for aCL was determined by age, sex, the presence of OLP, and HCV infection.

Anticardiolipin antibodies in first- and second-trimester pregnancy loss

Objective: To determine whether a difference exists in the prevalence of anticardiolipin antibodies in patients with a history of recurrent first- versus second-trimester pregnancy loss. Methods: Patients presenting to the Pregnancy Loss Evaluation Service (PLES) from June 1994 to December 1999 were tested for the presence of anticardiolipin IgG, IgM, and IgA antibodies. Levels were measured by a single reference laboratory test. Patients were eligible for the service if they had experienced recurrent first-trimester losses (RFTLs) or at least one second-trimester loss (STL). Comparisons based on the presence of the anticardiolipin antibody were made between patients with RFTL versus STL. Significance was set at P less than 0.05. Results: Anticardiolipin antibody levels were obtained in 93% (243/261) of patients during PLES evaluations. There were 132 patients with RFTL and 129 patients with a STL. 1st-trimester loss 2nd-trimester loss P value Anticardiolipin IgG 6.1% (8/130) 4.4% (5/113) 0.49 Anticardiolipin IgM 7.1% (9/126) 1.7% (2/115) 0.08 Anticardiolipin IgA 2.2% (2/88) 0% (0/78) 0.18 Conclusion: Although the prevalence of anticardiolipin antibodies is greater in patients with first-trimester losses, testing is justified in both first-trimester and second-trimester loss evaluations.

Anticardiolipin Antibodies in South African Patients with Lupus Nephritis: A Clinical and Renal Pathological Study

Aims: This study was conducted prospectively to ascertain the prevalence of anticardiolipin antibodies (ACAs) in patients with lupus nephritis and to determine whether this subgroup of patients differed clinically and histologically from patients without the antibody. Patients and Methods: 40 SLE patients (26 Blacks, 14 Indians, 37 females, 3 males) with evidence of renal involvement underwent clinical assessment and percutaneous renal biopsy. Special investigations included: urinary protein quantitation; radioisotope glomerular filtration rate (GFR); complement levels, and antinuclear antibodies and ACAs. Histology was reviewed by a single senior pathologist blinded to the ACA results. In addition to the standard WHO classification, specimens were examined for intrarenal thrombosis. Results: The prevalence of ACA was 45% (18 of 40 patients). Thrombocytopenia was more frequent in patients with ACA (33 vs. 13.6%, p = 0.015). Patients with ACA did not differ from controls with regard to the incidence of thrombosis, neurological disorders, recurrent fetal loss, active disease and hypertension. Mean GFR and 24-hour urine protein (ACA vs. controls) were 51.3 versus 67 ml/min (NS) and 2.4 versus 3.7 g (NS), respectively. Intrarenal microvascular thrombosis (glomerular and arteriolar) occurred in 27.7% of ACA patients versus 9% of controls (p = 0.025). Apart from a higher incidence of class-III nephritis in the controls, standard histology (WHO classification) did not differ between the 2 groups. Conclusion: The prevalence of ACA in our patients with lupus nephritis was 45%. This subgroup did not differ from patients without the antibody apart from a higher incidence of thrombocytopenia and intrarenal microvascular thrombosis.