Antiphospholipid Antibodies and the Antiphospholipid Syndrome in Systemic Lupus Erythematosus A Prospective Analysis of 500 Consecutive Patients

Alarcón‐Segovia, Donato; Delezé, Margarita; Cv, Oria; Sánchez‐Guerrero, Jorge; Gómez-Pacheco, Luis; Cabiedes, Javier; Fernández, Lorena Benavente; S, Ponce de León

doi:10.1097/00005792-198911000-00003

Cited by 604 publications

(254 citation statements)

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“…The presence of aPL has been shown to variably increase risk for the development of these clinical symptoms from 2-fold to 10-fold, consistent with the notion that they play an important role in disease pathogenesis (7)(8)(9)(10)22). They have further been demonstrated to often precede these clinical events, although by an unspecified amount of time (12)(13)(14)(15).…”

supporting

confidence: 54%

“…Thus, these antibodies are directed not only against negatively charged phospholipids, but also against portions of lipid-protein complexes. The lupus anticoagulant and anticardiolipin antibodies (aCL) have traditionally been shown to be associated with thrombotic symptoms of APS and SLE (7)(8)(9)(10)(11)(12)(13)(14)(15). However, aPL have also been shown to bind antigens such as prothrombin, annexin V, and ␤ 2 -glycoprotein I (␤ 2 GPI).…”

mentioning

confidence: 99%

“…Clinical symptoms associated with aPL include, but are not limited to, arterial and venous thrombosis, recurrent fetal loss, thrombocytopenia, hemolytic anemia, and aPL-associated nephropathy (7)(8)(9)(10)22). The presence of aPL has been shown to variably increase risk for the development of these clinical symptoms from 2-fold to 10-fold, consistent with the notion that they play an important role in disease pathogenesis (7)(8)(9)(10)22).…”

mentioning

confidence: 99%

“…In fact, studies have demonstrated that anywhere from 5% to 70% of lupus patients produce some type of aPL (9,10). However, very little is known about the actual prevalence and onset of aPL in patients prior to SLE diagnosis.…”

mentioning

confidence: 99%

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The prevalence, onset, and clinical significance of antiphospholipid antibodies prior to diagnosis of systemic lupus erythematosus

McClain¹,

Arbuckle²,

Heinlen³

et al. 2004

Arthritis & Rheumatism

171

126

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Objective. To determine whether antiphospholipid antibodies (aPL) occur before the diagnosis of systemic lupus erythematosus (SLE) and before initial clotting events, and whether their presence early in the disease course influences clinical outcome.Methods. Serum samples obtained from 130 lupus patients before and after SLE diagnosis were screened for IgG and IgM aPL using an anticardiolipin (aCL) enzyme-linked immunosorbent assay. Medical records of all patients were carefully reviewed for data on the time of onset of SLE features meeting clinical criteria and on disease manifestations.Results. Twenty-four patients (18.5%) were positive for IgG and/or IgM aCL prior to SLE diagnosis. Anticardiolipin antibodies appeared from 7.6 years prior to SLE diagnosis to within the same month as SLE diagnosis, with a mean onset occurring 3.0 years before SLE diagnosis. Additionally, aCL presence early in the disease process seemed to predict a more severe clinical outcome; these patients eventually met an average of 6.1 of the 11 classification criteria for SLE, compared with 4.9 criteria for other patients (P < 0.001). The early aCL-positive population also had more frequent renal disease, central nervous system disease, thrombocytopenia, and clotting events. In this population, aCL preceded initial thrombotic events by a mean of 3.1 years.Conclusion. Anticardiolipin antibodies in SLE patients tend to precede initial clotting events by several years. Furthermore, the presence of early, prediagnosis aPL seems to herald a more varied, severe clinical course with earlier onset in patients with SLE.

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confidence: 54%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The prevalence, onset, and clinical significance of antiphospholipid antibodies prior to diagnosis of systemic lupus erythematosus

McClain¹,

Arbuckle²,

Heinlen³

et al. 2004

Arthritis & Rheumatism

171

126

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“…Patients with high titers of aPL are prone to a variety of thrombotic episodes and to fetal loss (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Antiphospholipid antibodies can be detected by lupus anticoagulant (LAC) assay or by enzyme immunoassays (EIA) against phospholipids.…”

mentioning

confidence: 99%

Antibodies to β₂‐glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus

Tsutsumi

Matsuura

Ichikawa

et al. 1996

Arthritis & Rheumatism

211

109

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Objective. To investigate whether anticardiolipin antibodies (aCL) in patients with systemic lupus erythematosus (SLE) bind to β2‐glycoprotein I (β2GPI), and to search for a relationship between the presence of IgG and/or IgM anti‐β2GPI antibody and clinical manifestations in SLE patients. Methods. IgG and IgM anti‐β2GPI in 308 Japanese SLE patients were measured using phospholipid‐independent enzyme immunoassays. Relationships to clinical histories and to various laboratory data were examined. Results. The values of anti‐β2GPI and aCL, as measured by conventional enzyme immunoassay, showed a strong correlation, but the anti‐β2GPI assay was more useful in distinguishing β2GPI‐dependent aCL from β2GPI‐independent aCL. The presence of IgG anti‐β2GPI was associated with an increased frequency of a history of thrombosis. Comparisons of various laboratory data suggested that the titer of anti‐β2GPI may fluctuate with disease activity. Conclusion. The results suggest that pathogenic aCL is directed against structurally altered β2GPI and that enzyme immunoassay for anti‐β2GPI may prove useful in evaluating the risk of thrombosis and monitoring the clinical course in patients with SLE.

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Anticardiolipin Antibodies in Pediatric Systemic Lupus Erythematosus

Ravelli

Caporali

Fuccia

et al. 1994

Arch Pediatr Adolesc Med

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Antiphospholipid Antibodies and the Antiphospholipid Syndrome in Systemic Lupus Erythematosus A Prospective Analysis of 500 Consecutive Patients

Cited by 604 publications

References 0 publications

The prevalence, onset, and clinical significance of antiphospholipid antibodies prior to diagnosis of systemic lupus erythematosus

The prevalence, onset, and clinical significance of antiphospholipid antibodies prior to diagnosis of systemic lupus erythematosus

Antibodies to β₂‐glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus

Anticardiolipin Antibodies in Pediatric Systemic Lupus Erythematosus

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Antiphospholipid Antibodies and the Antiphospholipid Syndrome in Systemic Lupus Erythematosus A Prospective Analysis of 500 Consecutive Patients

Cited by 604 publications

References 0 publications

The prevalence, onset, and clinical significance of antiphospholipid antibodies prior to diagnosis of systemic lupus erythematosus

The prevalence, onset, and clinical significance of antiphospholipid antibodies prior to diagnosis of systemic lupus erythematosus

Antibodies to β2‐glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus

Anticardiolipin Antibodies in Pediatric Systemic Lupus Erythematosus

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Product

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Antibodies to β₂‐glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus