engleski

IgA antiphospholipid antibodies-a potential marker of thrombotic events?

Correlation between antiphospholipid antibodies (aPL) in systemic lupus erythematosus (SLE) with thromboembolic manifestation has been known for half a century. We studied 20 patients with confirmed autoimmune disease who developed deep venous thromboses. Clinically evident thrombosis was confirmed with phlebography. Their aPL profile was analyzed by ELSA using cardiolipin as antigen. The results were expressed in MPL, GPL, and APL units, and values over 20 were accepted as positive. The presence of LA was confirmed by neutralization with phospholipids using modified kaolin clotting time test. A sample was considered positive if the ratio was more than 1.2. There were 20 patients, 17 women and 3 men, with mean age 40 years. There were 16 patients with SLE and 4 with rheumatoid arthritis (RA). Five of them developed subclavian venous thromboses and 15 had thrombosis of deep veins of the legs. Fourteen patients were positive for lupus anticoagulant. During the anticoagulation treatment we retested anticardiolipin antibodies ; IgG, IgM. We also tested the values of IgA in order to evaluate whether there is any relation between IgA aCL and thromboembolic events. Persistently high level of IgG aCL was noticed in patients with SLE and subclavian vein thrombosis (mean 102.43 GPL). The values of IgA aCL correlated with IgG aCL values (mean 96.37 aPL), while the values of IgM aCL were within normal range. The same relation between levels of antiphospholipid antibodies was found in patients with RA with deep venous thrombosis of the legs, although with lesser elevations of antibody titers. In al patients with SLE and deep venous thrombosis of the leg we found elevated IgA aCL values (mean 43 aPL), while 6 had elevated IgG aCL values (mean 41 GPL), and 5 had elevated IgM aCL values (mean 27 MPL). Though the sample is small, and the exact mechanism of action of IgA aCL is not known, we can observe IgA aCL as potential marker of thromboembolic events in autoimmune disease.

Thrombosis ; Antiphospholipid antibodies ; Risk

nije evidentirano