Prevalence Of Antiphospholipid Antibodies Research Articles

Clinical study of giant cell arteritis in our hospital.

To investigate clinical and laboratory features of giant cell arteritis (GCA). We included 24 patients (6 men, 18 women; mean age 69.8 years) in this study. GCA was diagnosed based on the American College of Rheumatology 1990 classification criteria. Mean serum C-reactive protein was 9.03 mg/dl. GCA was classified into three types: classic temporal arteritis type (cranial GCA, nine patients); large-vessel type, affecting the aorta and its major branches without temporal arteries (12 patients); generalized type, affecting both temporal arteries and large vessels (three patients). Swelling and tenderness of temporal arteries were recognized in temporal arteritis and generalized arteritis. Ten of these patients also had histopathologic findings of arteritis, including giant cells in biopsy specimens. Examination of HLA-class 1 expression showed that one patient with cranial GCA, three with generalized GCA, and seven with large-vessel GCA were positive for HLA-A24, and four patients with large-vessel GCA were positive for HLA-B39. One patient with cranial GCA, one with generalized GCA, and six with large-vessel GCA were positive for HLA-B52. Nine patients were positive for anti-phospholipid antibodies (seven for anti-cardiolipin antibody immunoglobulin G, seven for anti-cardiolipin β2-glycoprotein-1 antibody, one for lupus anticoagulant). Our study demonstrated that HLA-class 1 expression in GCA resembles that in Takayasu arteritis, suggesting that these two arteritis types share the same genetic background. In contrast, the difference in the prevalence of anti-phospholipid antibodies in GCA and Takayasu arteritis patients shows a difference in the characteristic aspects of these two arteritis types.

Prevalence of antiphospholipid antibodies in patients with sterility undergoing ‘in vitro’ fertilization

Prevalence of antiphospholipid antibodies in patients with sterility undergoing ‘in vitro’ fertilization

Splenic Infarction as the Initial Manifestation of Antiphospholipid Syndrome in a Systemic Lupus Erythematosus Patient

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease. In patients with SLE, the prevalence of antiphospholipid antibodies is considerably higher, and is largely responsible for thrombosis. Splenic infarction is a rare complication of arterial thrombosis in patients with SLE. It is important to consider splenic infarction in a patient with SLE complaining of left upper quadrant (LUQ) pain because of the possibility of severe infarction-related complications, such as subcapsular hemorrhage and splenic rupture. We report a case of solitary splenic infarction in a patient with SLE. The only symptom was LUQ pain of 3-day duration. Lupus anticoagulant activity was positive and abdominal-pelvic computed tomography (CT) was consistent with splenic infarction. She did not show any other evidence of thrombotic events. The patient was diagnosed with antiphospholipid syndrome that presented as a splenic infarction in a SLE patient. (Korean J Med 2014;86:651-654)

Prevalence of antiphospholipid antibodies in psychiatric patients users and non‐users of antipsychotics

Past reports have suggested that antiphospholipid (aPL) antibodies may emerge as a response to antipsychotics treatment, as a high prevalence of aPL antibodies in antipsychotics users has been observed. However, no control group of non-medicated psychiatric patients was included in these reports. In a cross sectional study we determined the prevalence of aPL antibodies in 333 psychiatric inpatients. We compared the proportions of positive aPL antibodytests between users and non-users of antipsychotics with adjustments for potential confounders. The proportion of antipsychotics users carrying at least one aPL antibody ranged from 10·8% to 27·0% compared with 6·8% to 27·2% in non-users (P=0·24, P=0·24) depending on the method of detection of lupus anticoagulant (LA). The prevalence of LA detected by dilute Russell viper venom time or partial thromboplastin time-LA was not different between antipsychotics users and non-users (8·1% vs. 5·4%, P=0·53 and 18·4% vs. 18·2%, P=0·22), as well as the prevalence of IgM and IgG anti-β2-glycoprotein-I antibodies, IgM and IgG anti-cardiolipin antibodies(3·8% vs. 2·0%, P=0·75, 0·0% vs. 0·0%, P=not applicable, 1·1 vs. 1·4%, P=0·91, 2·7% vs. 3·4%, P=0·71). In conclusion, aPL antibodies were frequently found in patients with psychiatric diseases and no significant increase in the prevalence of aPL antibodies was observed in antipsychotics users.

Prevalence of Antiphospholipid Antibodies in Sample of Iraqi Patients with Systemic Lupus Erythematosus: A Cross Sectional Study

Objective: Antiphospholipid antibodies (APLAs) have high risk of vascularthrombosis with significant clinical comorbidities. Anticardiolipin antibodies (ACLAs)and Lupus anticoagulant (LA) are important APLAs. The aim of this study was to evaluate the prevalence of APLAs(ACLAs and LA) and their clinical significance among sample of Iraqi patients with systemic lupus erythematosus patients (SLE). Patients and methods: A single center cross sectional study conducted on 50 SLE patients diagnosed according to the 1997 revised American College of Rheumatology (ACR) criteria for SLE from February 2010 to April 2011. Patients' age at SLE diagnosis, disease duration, SLE disease activity index (SLEDAI), renal involvement, cerebral involvement, cardiac involvement, pregnancy events, and thrombotic events were analyzed. Serum samples were extracted and screened for IgG and IgM using an anticardiolipin (ACL) enzyme-linked immunosorbent assay, Lupus anticoagulant (LA), prothrombin time (PT), partial thromboplastic time (PTT), kaolin clotting time (KCT), and KCT index were assessed in all patients. Results: Of 50 SLE patients, the prevalence of positive anticardiolipin antibodies (ACLA) was 10(20%) and positive LA 5 (10%). Abnormal KCT12 (24.5%), Abnormal KCT index 5(10), Abnormal PTT2 (4.1%), and Abnormal PT 2(4%). Thrombotic events, pregnancy events, and cerebral involvement were associated with positive serology (P = 0.000, 0.225, 0.083 respectively). Renal and cardiac involvement were associated with negative serology (P = 0.019, 0.094 respectively). No new thrombotic events were found. Conclusions: Prevalence of positive ACLAs was 20% and positive LA 10%. Thrombotic events, pregnancy events, and cerebral involvement were associated with positive serology while renal and cardiac involvement with negative serology. We suggest screening SLE patients for the presence of APLAsand larger sample with longer follow up for their clinical manifestations.

Diskussionnye voprosy vedeniya zhenshchin s antifosfolipidnymi antitelami pri primenenii VRT

There are many controversies in the management antiphospholipid antibodies-positive women undergoing assisted reproductive technologies. Controversial and important is not only the effect of antiphospholipid antibodies (APA) on the success of IVF, but also approaches to the management of this group of women. The aim of this work was to study the prevalence of antiphospholipid antibodies in women with 3 or more IVF failures and effectiveness of IVF in women with APA treatment with membrane plasmapheresis before IVF and intravenous immunoglobulin during IVF. In women with 3 or more IVF implantation failure APA were detected in 35.95 % of cases. The use of intravenous immunoglobulin along with the standard therapy is a safe and effective for improvement of IVF outcomes in women with antiphospholipid syndrome (APS) or the presence of APA. The most effective is a combination of the membrane plasmapheresis therapy before IVF and intravenous immunoglobulin during IVF standard therapy including LMWH and low-dose aspirin in IVF protocol. This therapy in patients with the presence of APA increases the pregnancy rate after IVF to 46.15 %.

P-087 Prevalence of antiphospholipid antibodies in women with stillbirths and normal embryo karyotypes

P-087 Prevalence of antiphospholipid antibodies in women with stillbirths and normal embryo karyotypes

Frequency of specific coagulation inhibitors and antiphospholipid antibodies in Tunisian haemophiliacs

Production of factor VIII or factor IX inhibitors is a major complication limiting the efficiency of substitutive therapy in haemophiliacs. Moreover, viral infections, the second serious complication of replacement therapy, may be associated to the occurrence of antiphospholipid antibodies which paradoxically lead to thrombosis. We investigated the prevalence of coagulation inhibitors (factor VIII and factor IX inhibitors, antiphospholipid antibodies) in Tunisian haemophiliacs, and we assessed concomitant coagulation factor deficiencies. Thirty-two previously treated haemophiliacs (20 haemophiliacs A; 12 haemophiliacs B) were screened for factor VIII and factor IX inhibitors by APTT mixing study, Bethesda test and modified Nijmegen method, and investigated for the presence of anticardiolipin, anti-β2 glycoprotein I, lupus anticoagulant and associated coagulation factors deficiencies. The frequency of factor VIII and factor IX inhibitors was low (5%) in contrast to the high prevalence of antiphospholipid antibodies (28.1%). Four and nine patients were positive for anticardiolipin and anti-β2 glycoprotein I, respectively. No lupus anticoagulant was detected. The prevalence of antiphospholipid antibodies was higher in patients with positive hepatitis C virus infection serology as compared to patients with negative serology (41.6% vs. 20%). Concomitant factor VII and/or factor V deficiency was found in 10 patients. In conclusion, the occurrence of factor VIII and factor IX inhibitors is rare among Tunisian haemophiliacs. The clinical relevance of antiphospholipid antibodies requires further investigations. We emphasize the importance of screening for concomitant deficiencies in haemophiliacs when the clinical presentation is suggestive.

¿Se deben tratar preventivamente los pacientes asintomáticos con anticuerpos antifosfolípidos?

The prevalence of antiphospholipid antibodies (aPL) in the general population is 1%. Not all asymptomatic patients with aPL antibodies have the same risk for thrombosis, and consequently routine prophylaxis with acetylsalicylic acid (ASA) is not justified in terms of risk-benefit in all asymptomatic carriers. Based on current evidence, primary prevention is indicated only in high-risk groups including the following: a)in patients with anticardiolipin antibodies (aCL) at persistently high titers, repeatedly positive lupus anticoagulant (LA) or aCL positivity, LA and anti-beta2 glycoprotein I (triple positivity) regardless of titer; b)in situations of high thrombotic risk due to the concomitant presence of other thrombotic risk factors (hypertension, immobilization, surgery, etc.); c) in the presence of a systemic autoimmune disease, particularly systemic lupus erythematosus, and d) during pregnancy. Prophylactic treatment in these patients is based on the use of ASA. In specific situations, low-molecular-weight heparin and hydroxychloroquine are also useful.

Prevalence of antiphospholipid antibodies in rheumatoid arthritis patients and relationship with disease activity

It is still unclear how important the presence of antiphospholipid antibodies (aPL) is in patients with rheumatoid arthritis (RA). The aim of the study was to assess the prevalence of selected aPL in RA patients and their correlation with the presence of markers for RA antibodies and with disease activity. The study group consisted of 97 patients with RA who had never been treated with biological agents. In all patients, serum anticardiolipin antibodies (aCL), anti‑β2‑glycoprotein I antibodies (a‑β2‑GPI), lupus anticoagulant (LAC), immunoglobulin M (IgM) rheumatoid factor (RF), and anticyclic citrullinated peptide antibodies (anti‑CCP) were measured and disease activity was assessed. The presence of aPL was observed in 27 patients (27.8%): aCL in 20 patients (20.6%), a‑β2‑GPI in 12 patients (12.4%), and LAC in 1 patient (1%). Positive aCL of low or medium levels were detected in the IgM class in 11 patients (11.3%) and in the IgG class in 12 patients (12.5%). Positive a‑β2‑GPI of low and medium levels were found only in the IgM class. The presence of LAC was associated with aCL‑IgM and a‑β2‑GPI‑IgM. A significant correlation was observed between the presence of anti‑CCP and different types of aPL. There was no correlation between aPL and IgM‑RF or disease activity markers. The prevalence of aPL in patients with RA is relatively high. There is a relationship between the prevalence of aPL and anti‑CCP-serological marker of RA, but there are no significant correlations between disease activity and the presence of aPL.

Does Immunotherapy for Treatment of Reproductive Failure Enhance Live Births?

Before effective treatment for reproductive failure can be instituted, the cause of the failure must be determined. A search of PubMed was made to identify the published data regarding diagnosis and treatment of reproductive failure. Results were compared with the frequency of antiphospholipid antibodies (APA) in 2995 women with histories of unexplained infertility, recurrent implantation failure, recurrent pregnancy loss, and fertile women. In addition, pregnancy outcomes among 442 women experiencing reproductive failure and elevated NK cell activity after treatment with intravenous immunoglobulin (IVIg) (N = 242) or intralipids (N = 200) were compared. The prevalence of APA was the same among women with the diagnosis of unexplained infertility, recurrent implantation failure, and recurrent miscarriage. Heparin and aspirin are successful in the treatment of elevated APA among women with recurrent miscarriage but not with recurrent implantation failure. IVIg has been successful in the treatment of recurrent miscarriage and recurrent implantation failure among women with elevated APA and/or NK cell activity. When the pregnancy outcomes of women with a history of reproductive failure and elevated NK cell cytotoxicity treated with intralipid were compared with women treated with IVIg, no differences were seen. Immunotherapy for treatment of reproductive failure enhances live birth but only in those women displaying abnormal immunologic risk factors.

Prevalence and clinical usefulness of antiphospholipid and anticofactor antibodies in different Spanish preeclampsia subsets

To study the prevalence and clinical usefulness of antiphospholipid antibodies in different preeclampsia subsets. Observational cross-sectional study. Tertiary teaching hospital. Ninety-nine women with preeclampsia versus 83 healthy pregnant women as controls. We analysed anticardiolipin IgG/IgM, anti-ß(2)glycoprotein IgG/IgM, antiphosphatidylserine IgG/IgM, antiAnnexin-A5 IgG/IgM, and lupus anticoagulant. Comparison of antiphospholipid antibody positivity between groups. Antiphospholipid antibody prevalence was 14.14% in the study group vs. 7.23% in controls. Excluding antiAnnexin-A5-positive women, overall antiphospholipid prevalence was 13.19% vs. 3.61% (p = 0.034). Only IgM-anticardiolipin positivity showed significant differences between preeclampsia group and controls (8.1% vs. 1.20%, p = 0.041). Comparing a severe preeclampsia subset vs. controls, we obtained these significant results: for two or more positive antiphospholipid tests: 9.09% vs. 1.20 (p = 0.037); IgM-anticardiolipin 10.91% vs. 1.20% (p = 0.016); IgG/IgM-anti-ß(2)glycoprotein-I 10.91% vs. 1.90% (p = 0.016), IgM-anti-ß(2)glycoprotein-I 9.09% vs.1.20 (p = 0.037). When comparing early-onset preeclampsia vs. controls we found IgM-anticardiolipin 11.11% vs. 1.20% (p = 0.029). Prevalence of antiphospholipid antibodies in preeclampsia patients is twice that in healthy pregnant women. Multipositive aPL test, IgM-anticardiolipin and IgM-anti-ß(2)glycoprotein-I isotypes showed an association with severe and early-onset preeclampsia. Larger studies are needed to establish the usefulness of antiphospholipid tests as risk markers for severe and early onset preeclampsia.

Profil des anticorps antiphospholipides et risque de thrombose : étude comparative entre thrombopénie immunologique chronique et syndrome des antiphospholipides primaire

Purpose The prevalence of antiphospholipid antibodies (APA) in patients with immune thrombocytopenic purpura (ITP) varies from 25 to 75% in the literature. The risk of thrombosis in this subgroup of patients is debated. In parallel, thrombocytopenia is present in 22 to 42% of patients with antiphospholipid syndrome (APS). Patients et methods The main study objective was to compare the profile at diagnosis of lupus anticoagulant (LA), anticardiolipin antibody (ACL) and anti-β 2GP-I antibody between a cohort of 93 chronic ITP patients and a cohort of 27 primary APS patients. The secondary objectives were: to evaluate the risk of thrombosis in ITP patients depending on the presence of APA; to compare the profile of APA and to assess the occurrence of lupus in APS patients depending on the presence of thrombocytopenia. Results In ITP patients, the prevalence of APA was 25%; association of several different APA was less frequent than in APS patients; mean titles of ACL and anti-β 2GP-I antibodies were comparable between the two cohorts; two spontaneous venous thromboses occurred in ITP patients, with no particular profile of APA (median follow-up: 36 months). Thrombocytopenia was present in 26% of APS patients; it was always moderate and asymptomatic, and sometimes intermittent; no particular profile of APA was associated to thrombocytopenia; only one thrombocytopenic patient developed a systemic lupus and no particular profile of APA could be found associated (median follow-up: 48 months). Conclusion ITP patients with APA have less frequently an association of different APA than APS patients do; their risk of thrombosis appears low.

Essential Thrombocytosis and Antiphospholipid Antibody Syndrome Causing Chronic Budd-Chiari Syndrome

Essential thrombocytosis is extremely rare in children. However, when present, it is associated with increased prevalence of antiphospholipid antibodies and thrombo-hemorrhagic complications. The authors report here a child with Budd-Chiari Syndrome resulting from essential thrombocytosis and associated antiphospholipid antibodies. A 13- y-old boy presented with microcytic hypochromic anemia, hepatosplenomegaly and thrombocytosis. CT scan demonstrated calcified thrombus in inferior vena cava (IVC). Diagnosis of essential thrombocytosis was considered in view of persistent thrombocytosis, antiphospholipid antibodies, bone marrow showing increased number, clusters and giant forms of megakaryocytes and IVC thrombosis. He was started on warfarin prophylaxis and did not have thrombotic recurrence on follow up.

Prevalence of antiphospholipid antibodies among women experiencing unexplained infertility and recurrent implantation failure

The prevalences of antiphospholipid antibodies (APAs) among 1,325 women with a history of unexplained infertility and 676 women experiencing recurrent implantation failure were compared with 789 women experiencing recurrent pregnancy loss and 205 fertile control women. Eight percent and 9% of women with a history of unexplained infertility and recurrent implantation failure had more than one positive APA compared with 1.5% of fertile negative control women and 11% of positive control women experiencing recurrent pregnancy loss.

Prevalence of antiphospholipid antibodies in Syrian patients with thrombosis.

Antiphospholipid antibodies (aPL) are a heterogeneous family of antibodies associated with thrombosis and other complications. To study the prevalence of aPL in patients with thrombosis at Aleppo University Hospitals, Syria. One hundred and fifty-seven patients with venous and arterial thrombosis and 63 healthy controls were studied. Anticardiolipin antibodies (aCL) and Lupus anticoagulant (LA) were determined. Thirty-four out of 157 (21.7%) patients with thrombosis had some type of aPL. aPL was also found in four healthy subjects (4/63=6.3%). Eighteen patients (11.5%) were positive for LA, 20 (12.7%) for aCL antibodies and 4 (2.6%) were positive for more than one aPL. Patients without risk factors for thrombosis and having positive aPL were 23/34 (67.7%). Fourteen out of 78 (17.9%) patients with arterial thrombosis, and 20/79 (25.3%) with venous thrombosis were positive for at least one aPL. Our study showed a significant prevalence of aPL in patients with thrombosis. It seems that aPL is a risk factor for venous and arterial thrombosis, especially in patients with no conventional risk factors.

Prevalence of antiphospholipid antibodies among women with unexplained infertility

OBJECTIVE: To define whether antiphospholipid antibodies (APA) are associated with unexplained infertility (UI) as they are with other reproductive problems DESIGN: Case-control study MATERIALS AND METHODS: 715 participants including 510 with unexplained infertility and 205 fertile control women had blood drawn for determination of 21 APA including IgG, IgM, and IgA anticardiolipin (CL), antiphosphatidyl ethanolamine (PE), antiphosphatidyl inositol (PI), antiphospatidic acid (PA), anti phosphatidyl glycerol (PG), antiphosphatidyl choline (PC), and antiphosphatidyl serine (PS) by ELISA . RESULTS: The frequencies of APA among women with UI compared with fertile controls are listed in Table. More than 1 positive APA was noted in 12% of women with UI compared with 1.5% of control women (P=0.002).Tabled 1Table. The percent positives for all 21 different APA among women with UI and with fertile controls.Antiphospholipid Ig GUI % (n=510)Controls % (n=205)P-valueCL5.50.50.004PE2.72.4NSPI4.31.9NSPA11.24.90.01PG5.91.90.04PC3.71.5NSPS1.44.9NSAntiphospholipid Ig MCL1.61.9NSPE0.21.9NSPI1.80.9NSPA2.40.9NSPG1.80.5NSPC7.80.90.0008PS1.90.5NSAntiphospholipid Ig ACL0.20.9NSPE1.21.5NSPI0.90.9NSPA00.9NSPG0.60.9NSPC0.80.5NSPS00.5NS Open table in a new tab CONCLUSIONS: APA appears to be significantly associated with UI.

Clinical significance of antiphospholipid antibodies in Indian scleroderma patients

In patients with systemic sclerosis (SSc), antiphospholipid antibodies (aPL) have been reported to be associated with more severe manifestations including digital infarct, gangrene and pulmonary hypertension. But these findings are not consistent in all studies; moreover, there are no data available from Indian subcontinent. The objective of this study is to assess the prevalence of antiphospholipid antibodies in Indian SSc patients and correlate them with clinical and immunological features. Seventy-two patients were recruited prospectively from rheumatology clinic from 2002 to 2006. Their medical records were reviewed. Anticardiolipin antibodies (IgG, IgM) by ELISA and lupus anticoagulant (LA) were tested in standardized pattern and repeated after 6 weeks. Anti-β2 glycoprotein-I antibodies were done in patients who had aPL antibodies. Nineteen patients had diffuse cutaneous SSc and 53 had limited disease. Seven patients (9.7%) were positive for aPL antibodies in their sera. Only one patient had clinical features of antiphospholipid antibody syndrome and manifested with recurrent abortions and deep vein thrombosis. She was positive for aCL, LA and anti-β2 glycoprotein-I antibodies. Four patients were only aCL (IgG) positive in moderate titers and one each had only aCL (IgM) and LAC positivity. None of the clinical parameters showed an association with aPL antibody.

Prevalence Of Antiphospholipid Antibodies In Pregnant Women At A Secondary Health Care Institution In Lagos

OBJECTIVE: The presence of antiphospholipid antibody has been associated with complications in pregnancy; hence the need to determine the prevalence of this antibody in pregnant women attending the ante-natal clinic in a secondary health care institution inLagos metropolis using screening tests.SUBJECTS AND METHODS A cross-sectional study was carried out on a total of one hundred and thirty one (131) women attending obstetrics and gynaecology clinic at the General hospital Surulere Lagos from 1 st to 18 th February 2005. Out of these attendees, 37 were non-pregnant, 31 were pregnant with no complications in pregnancy (apparently normal) and 63 pregnant women with complications in pregnancy. Blood samples were collected from ante-natal patients after obtaining informed consent. The plasma of all the samples were subjected to kaolin clotting time and the serum of forty-three (43) of the samples were run on an enzyme-linked immunosorbent assay (ELISA) for the semi quantitative determination of IgG and IgM anticardiolipin antibodies.RESULTS: A prevalence of 9.3% was obtained for the antiphospholipid antibodies by the coagulation-based kaolin clotting time, and 2.3% by a more sensitive immunological-based ELISA test on the same set of patients.CONCLUSION: In order to avoid false positive results, it is recommended that immunological-based ELISA test be carried out on patients that test positive to kaolin clotting time and/or have clinical features suggestive of the presence of antiphospholipid antibody before they are commenced on therapy.

Antiphospholipid Antibodies and Acute-Phase Response in Non-Metastatic Colorectal Cancer Patients

Aim To investigate the plasma levels and prevalence of the most common antiphospholipid antibodies, as well as their relationships with several plasma markers of inflammation, in order to characterize some aspects of cancer thrombophilia. Materials and methods Eighty-three cancer patients with non-metastatic colorectal solid tumors and 94 control subjects were tested for the presence of IgG/IgM/IgA anti-cardiolipin and anti-β2-glycoprotein I antibodies and of several acute-phase reactants, i.e., fibrinogen, factor VIII:C and C4b-binding protein. Results In cancer patients the plasma levels of the acute-phase reactants and the IgA/IgG anti-cardiolipin and IgA anti-β2-glycoprotein I antibodies were significantly higher; the acute-phase reactants were significantly correlated with anti-cardiolipin antibodies; the prevalence of antiphospholipid antibodies was not significantly higher. Conclusions In patients with non-metastatic colorectal cancer the acute-phase response is associated with antiphospholipid generation. This could represent a further pathogenetic mechanism for the short-term post-surgery thrombotic complications of patients with colorectal cancer.