Distribution and Clinical Significance of Lupus Anticoagulant and Anticardiolipin Antibody in 349 Patients with Systemic Lupus Erythematosus.

Abstract

Samples from 349 patients with systemic lupus erythematosus (SLE) were tested simul taneously for lupus anticoagulant (LAC) and anticardiolipin antibodies (ACL). LAC was detected in 27.2% of 349 SLE patients by a modified mixing kaolin clotting time. ACL was detected in 34.7% by enzyme-linked immunosorbent assay. Only half of the patients who had LAC or ACL were positive for both of them. In addition, isotypes of ACL in these patients were studied. The IgG isotype was detected in 81.8% of 121 patients, and more than half had only the IgG isotype. When clinical features of patients with LAC or ACL were studied, the incidence of thrombosis, fetal loss, and thrombocytopenia were significantly higher in both groups compared with patients without LAC or ACL. In particular, the patients with both LAC and ACL showed the highest risk of fetal loss (89%) during pregnancy. These results indicate that LAC and ACL are detected in partly different groups of SLE patients, but both of these groups are clinically similar.

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“…Anticardiolipin is probably the most classical aPL, as it is used for the definition of APS. It is highly associated with recurrent pregnancy loss, but also with other manifestations of APS such as focal CNS involvement (2,3). Animal model support the pathogenic role of anticardiolipin in pregnancy (4).…”

Orthopedic Involvement in Antiphospholipid Syndrome

“…Glucocorticoid use was recognized as an important risk factor of osteonecrosis [18]. aPL can be detected in 30-50% of SLE patients [19][20][21]. There has been increasing interest in aPL as a potential cause of osteonecrosis in SLE.…”

Risk Factors for Recurrent Thrombosis: Prospective Study of a Cohort of Japanese Systemic Lupus Erythematosus

“…Lupus anticoagulant (LAC) was detected by the modified mixing Kaolin clotting time as described previously. 10,11 Immunoglobulin G (IgG) anticar-diolipin antibodies (aCLIgG) were measured by a recently developed ELISA Kit "MESA CUP Cardiolipin Test" (MBL Co., Tokyo, Japan) (normal value <1.0 U/mL), which consists of the method described by Harris et al 12 b2glycoprotein I-dependent aCL (b2GP1-aCL) was measured by EIA Kit "Anti CL b2 GP1 Kit" 13 (Yamasa Sho-yu Co., Chiba, Japan) (normal value <1.2 U/mL).…”