Prevalence and clinical correlates of anti‐phospholipid antibodies in South Africans with systemic lupus erythematosus

Abstract

were documented, and sera tested for aCL, aβ 2 GP, and aPT of all isotypes, and LA.RESULTS: Positive aCL, aβ 2 GP1 and aPT and LA were found in 53, 84, 20, and 2 patients, respectively. Immunoglobulin (Ig)A aCL and IgG aβ 2 GP1 were the commonest aCL (49.1%) and aβ 2 GP1 (47%) isotypes, respectively. IgA aβ2GP1 were associated with both a history of thrombosis alone (p<0.05) and a history of any clinical feature, thrombosis and/or spontaneous abortion of the APS (p<0.05); IgA aCL were associated with a history of any clinical APS event (p<0.05); and aβ2GPI of any isotype were associated with a history of arthritis (p<0.001).CONCLUSION: My findings provide further evidence that the screening for aβ 2 GP1 and IgA aCL isotype may improve the risk assessment for APS in SLE patients of African extraction.

The diagnostic utility of the anti-CCP antibody test is no better than rheumatoid factor in South Africans with early rheumatoid arthritis

“…The high false positive rate for aCCP in the SLE group might also be on the basis of non-specific increases in globulins in people of African origin as found previously with respect to antiphospholipid antibodies in SLE [21]. In light of the high occurrence of TB in our SLE patients (13), a further possible explanation is that some of these patients may be harbouring latent TB.…”

The implications of autoimmunity and pregnancy

“…While some studies identify antiprothrombin antibodies as a strong risk factor for early pregnancy loss in APS patients [39,43], others do not detect a significant association in APS or SLE patients [31,32,51] or women with recurrent miscarriages in Italian women [41]. Anti-annexin V antibodies have been found to be significantly associated with recurrent miscarriage in studies from such geographically diverse areas as Italy, Tunisia, and Japan [39,41,44,46,52], but this is not a consistent finding either [34,53].…”

“…Notably, both IgG aCL and IgG anti-b2GPI were associated with thrombosis and fetal loss in Colombian as well as Spanish SLE patients; however they were additionally associated with livedo reticularis among Spaniards, but with thrombocytopenia in Colombians. There are numerous indications that IgA is the most frequent isotype of aCL and anti-b2GPI antibodies in African American as well as South African APS and SLE patients [37,51,60,61]. Although generally aCL and/or anti-b2GPI of the IgG isotype are most strongly implicated in the clinical manifestations of APS, in two of these studies IgA aCL was found to be associated with thrombosis, but not with recurrent pregnancy loss in African American patients [61], and with any clinical APS manifestation in South African patients [51].…”

“…There are numerous indications that IgA is the most frequent isotype of aCL and anti-b2GPI antibodies in African American as well as South African APS and SLE patients [37,51,60,61]. Although generally aCL and/or anti-b2GPI of the IgG isotype are most strongly implicated in the clinical manifestations of APS, in two of these studies IgA aCL was found to be associated with thrombosis, but not with recurrent pregnancy loss in African American patients [61], and with any clinical APS manifestation in South African patients [51]. Unfortunately, aCL, LA, or anti-b2GPI of the IgA isotype are not routinely measured, and other data on their association with clinical manifestations are limited and controversial.…”

Effect of ethnicity on clinical presentation and risk of antiphospholipid syndrome in Roma and Caucasian patients with systemic lupus erythematosus: a multicenter cross‐sectional study

“…90%, P = 0.03). Prevalence of APS associated with lupus varies according to race (Table ). It has been reported that APS prevalence in Chinese SLE patients is lower than in the Caucasian population .…”