Antiphospholipid antibodies in systemic lupus erythematosus: Clinical and laboratory associations in 111 patients

Abstract

An enzyme linked immunosorbent assay (ELISA) was used to evaluate the prevalence and disease associations of antibodies to a range of negatively charged phospholipids in 111 patients with systemic lupus erythematosus (SLE). The frequency of one or more isotypes of different antiphospholipid antibodies (APLs) was similar (range 33%-45%). When individual isotypes were considered alone there was considerable variation (range 5%-32%). There were significant associations between thrombosis, thrombocytopenia, and central nervous system (CNS) disease but not abortion with elevated APL. Strong associations were found between raised anti-ds-DNA (Farr assay) and a positive direct Coomb's test with raised APL. Thus, APLs are common in SLE and are associated with discrete clinical and laboratory features. However, detection of antibodies to a range of negatively charged phospholipids added little clinically useful information to that obtained by measuring anticardiolipin antibody (ACL) alone. We cannot recommend the use of APLs other than ACL for routine testing.

Aetiological factors related to a positive direct antiglobulin test result in human immunodeficiency virus‐infected patients

“…However, in our study, the positive DAT results seem to play an independent role in effecting the Hb levels, indicating that of the patients receiving TMP‐SMX treatment, those with DAT‐positive results showed significantly lower Hb values. A confusing factor may be the low CD4 + counts in patients undergoing TMP‐SMX treatment – a condition characterized by the production of broad‐spectrum autoantibodies [5–8,34–37]. HAART treatment showed a benefit in reducing the frequency of positive DATs in patients with HIV.…”

Hematopoietic stem cell transplantation for severe and refractory lupus

“…Patient eligibility criteria included an established diagnosis of SLE and 1 of the following 5 features: World Health Organization class III or class IV glomerulonephritis (7), uncontrolled with treatment according to the National Institutes of Health short-course CYC protocol (8); parenchymal disease of the heart or lung with biopsy-proven vasculitis, uncontrolled with IV CYC; cerebritis or transverse myelitis, uncontrolled with IV CYC; profound, refractory autoimmune cytopenias; or catastrophic antiphospholipid syndrome (9)(10)(11)(12).…”

Systemic Lupus Erythematosus Presenting as Subacute Delirium in an 82‐Year‐Old Woman

“…The most common finding is noninflammatory vasculopathy characterized by small‐vessel intimal proliferation and immune‐complex deposition 10,20,21 . Antiphospholipid antibodies are thought to be associated with stroke, chorea, transverse myelitis, and impaired verbal memory; 22–24 antiribosomal antibodies variably with psychosis and depression; 25,26 antilymphocytotoxic antibodies with visual‐spatial and cognitive deficits; 27,28 and anti‐neuronal antibodies with cognitive impairment and diffuse cerebral events 29 . Anticardiolipid antibodies have been associated with impaired concentration, abstract thought, executive function, and processing speed 30,31 …”