Prevalence Of aPL In Patients Research Articles

Antiphospholipid Antibodies in Inflammatory and Autoimmune Rheumatic and Musculoskeletal Diseases Beyond Lupus: A Systematic Review of the Available Evidence.

BackgroundThe diagnosis of antiphospholipid syndrome (APS) requires the presence of thrombosis and/or recurrent miscarriages along with one or more anti-phospholipid antibodies (aPL). The role of aPL has been largely investigated in systemic lupus erythematosus (SLE) with minimal data on other autoimmune rheumatic diseases. In this review, we aim to assess the prevalence of aPL in patients with inflammatory and autoimmune rheumatic and musculoskeletal diseases (RMDs) other than SLE, and their association with thrombosis.ResultsA total of 20 studies, including 3242 patients, measured aPL in different inflammatory and autoimmune RMDs. The overall median percentage of aPL-positive patients was 14.05% (from 0 to 57.5%). For systemic sclerosis (SSc) patients, the median positivity was 14.05% for aPL, with IgG aCL being detected in up to 35.48% of all SSc aPL-positive patients. Only six studies (30%) performed an antibody confirmation test after 12 weeks, with the median prevalence being 10.88% (from 0 to 29.79%). Only six studies also assessed the number of double or triple aPL-positive patients. A total of eight (40%) studies including 1071 patients investigated the association between aPL and thrombotic events, namely five for SSc, one for SS, one for ANCA associated vasculitides (AAV), and one for RA. A median of 18.75% (7.69–71.43%) of aPL-positive patients experienced an arterial event in comparison to a median of 13.66% (7.69–31.25%) who underwent venous thrombotic event. Taking into consideration only the studies that performed a confirmation test, a median value of 34.36% (12.9–71.43%) of aPL-positive patients underwent an arterial event and a median value of 16.32% (9.68–25%) of aPL-positive patients underwent a venous event.ConclusionsAnti-phospholipid antibodies can be detected in up to a third of patients with inflammatory and autoimmune RMDs, especially in SSc. However, there was a large heterogeneity among the retrieved studies. Available data supporting a general screening for aPL in all inflammatory and autoimmune RMDs are still insufficient. Screening for aPL in selected scenarios (e.g., pregnancy planning) could be considered.

Increased risk of vascular complications in Takayasu’s arteritis patients with positive lupus anticoagulant

Objectives: Previous studies have shown antiphospholipid antibodies (aPL) to be prevalent in primary systemic vasculitides; however, the possible clinical impact of aPL positivity in such patients has not been explored in depth. The aims of this study were to determine the prevalence of aPL in patients with Takayasu’s arteritis (TA) and to ascertain whether aPL positivity was predictive of a worse clinical outcome in TA.Method: Clinical data were collected retrospectively on 22 TA patients over an 11-year period. Data collected included the presence of lupus anticoagulant (LA) and immunoglobulin (Ig)G and IgM anticardiolipin antibody (aCL) titres. Adverse clinical outcomes included cerebrovascular accident (CVA), transient ischaemic attack (TIA), loss of vision, vascular lesions (carotid, femoral, renal, coronary, or other vessels) requiring stenting, angioplasty, or other surgical intervention, aortic valve replacement, end-stage renal failure or death.Results: Persistently positive aPL or a concurrent diagnosis of antiphospholipid syndrome (APS) was found in 45% (n = 10) of TA patients while 55% (n = 12) had TA alone. LA was present in a significant proportion of TA patients with aPL (p = 0.002). Vascular complications occurred in 70% (n = 7) of TA patients with aPL and in 25% (n = 3) of TA patients without aPL (p = 0.035). LA was associated with a higher prevalence of vascular complications.Conclusions: Persistently positive aPL are present in a significant proportion of TA patients. This study shows that vascular complications and need for intervention are more prevalent in TA patients with aPL, particularly those with LA. Prospective studies are needed to determine the long term prognosis in such patients.

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.

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.

Antiphospholipid antibodies in alcoholic liver disease are influenced by histological damage but not by alcohol consumption.

Antiphospholipid antibodies (aPL) have been detected in various liver diseases, particularly cirrhosis. The role of alcoholic consumption per se has been suggested. The aim of our study was to assess the prevalence of aPL in patients with alcoholic liver disease at various states and to correlate the presence of aPL with both liver injury and alcoholic consumption. Three groups were prospectively included. Group A: 74 controls (age- and sex-matched); group B: 46 patients with alcoholic steatosis; group C: 28 patients with alcoholic cirrhosis. For each patient, lupus anticoagulant, anticardiolipin antibodies and anti-beta2-glycoprotein I antibodies were tested. The prevalence of aPL (presence of at least one positive test) was 5% in group A, 20% in group B and 50% in group C (P < 0.04). No correlation appeared between aPL and Child Pugh score in group C. No correlation was found between the presence of aPL and alcohol intake in patients with either steatosis or cirrhosis. Our study confirms that aPL positivity is more frequently encountered in patients with alcoholic liver disease than in controls. Their prevalence increases with the degree of histological damage but not with the level of alcoholic intake.