Atherosclerosis in systemic lupus: The role of antiphospholipid antibodies needs strict diagnostic criteria to be evaluated. Comment on the article by Urowitz et al

2010 ◽  
Vol 63 (1) ◽  
pp. 173-174
Author(s):  
Piero Stratta ◽  
Paola Mesiano ◽  
Andrea Campo ◽  
Loredana Colla ◽  
Fabrizio Fop ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Antiphospholipid Antibodies ◽  
Systemic Lupus

scholarly journals The Frequency of Phospholipid Antibodies in an Unselected Stroke Population

1998 ◽  
Vol 25 (1) ◽  
pp. 64-69 ◽  
Author(s):  
L.M. Metz ◽  
S. Edworthy ◽  
R. Mydlarski ◽  
M.J. Fritzler
Keyword(s):  
Ischemic Stroke ◽  
Systemic Sclerosis ◽  
Antiphospholipid Antibodies ◽  
Anticardiolipin Antibodies ◽  
Activated Partial Thromboplastin Time ◽  
Systemic Lupus Erythematosis ◽  
Stroke Patients ◽  
Systemic Lupus ◽  
Stroke Population

ABSTRACT:Background:Antibodies to cardiolipin and other phospholipids have been associated with recurrent thrombotic events, including stroke.Methods:Over a 16 month period we assessed an unselected cohort of 151 ischemic stroke patients for the presence of antiphospholipid antibodies. Patients with known systemic lupus erythematosis, systemic sclerosis, or Sjogrens Syndrome were excluded. Sera from patients admitted to hospital with a diagnosis of ischemic stroke (n = 151) and from controls (n = 111) assessed during the same period were tested for antiphospholipid antibodies (APLA) using 3 assays; anticardiolipin antibodies (ACA) by ELISA, prolonged activated partial thromboplastin time (APTT), and VDRL.Results:The average age of ischemic stroke cases was 68 years (range 29 to 91) and of controls 63 years (range 29 to 86). The prevalence of APLA detected by at least one of the three methods was 12% for IS cases and 10% for controls. After correcting for known risk factors such as age, gender, diabetes mellitus, heart disease, hypertension, and smoking, the odds ratio for risk of stroke fell to 0.8 (C.I. 0.4 to 1.2).Conclusions:Our findings suggest that APLA may not be an independent risk factor for ischemic stroke in unselected persons who do not have known systemic lupus erythematosis or systemic sclerosis but further evaluation of the role of lupus anticoagulant is indicated.

scholarly journals A 17-Year-Old Female with Systemic Lupus Presents with Complex Movement Disorder: Possible Relationship with Antiribosomal P Antibodies

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Muhammed Emin Özcan ◽  
Meriç Adil Altınöz ◽  
Hasan Hüseyin Karadeli ◽  
Talip Asil ◽  
Abdulkadir Koçer
Keyword(s):  
Movement Disorder ◽  
Antiphospholipid Antibodies ◽  
Sudden Onset ◽  
Systemic Lupus ◽  
Rare Presentation ◽  
Glycoprotein I ◽  
Neuronal Stimulation ◽  
Caucasian Female ◽  
Complex Movement

Complex movement disorder is a relatively rare presentation of neurolupus. Antiphospholipid antibodies are associated with movement disorders likely via aberrant neuronal stimulation. Antiribosomal P antibodies have been previously associated with neuropsychiatric disorders but their correlation with movement disorder was not previously established. Our case report involves a 17-year-old Caucasian female patient positive for only antiribosomal P antibody and lupus anticoagulant who presented with a sudden onset of complex movement disorder. After complete cessation of physical signs with olanzapine, anticardiolipin and anti-β2 glycoprotein I antibodies became positive which indicates a likely discordance between movement disorder and antiphospholipid antibodies. This also indicates a potential causal role of antiribosomal P antibodies in inducing movement disorder.

scholarly journals The role of clinically significant antiphospholipid antibodies in systemic lupus erythematosus

Reumatismo ◽  
2016 ◽  
Vol 68 (3) ◽  
pp. 137 ◽  
Author(s):  
M. Taraborelli ◽  
M.G. Lazzaroni ◽  
N. Martinazzi ◽  
M. Fredi ◽  
I. Cavazzana ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Multivariate Analysis ◽  
Lupus Erythematosus ◽  
Antiphospholipid Antibodies ◽  
Valvular Disease ◽  
Systemic Lupus ◽  
Increased Risk ◽  
Clinically Significant ◽  
Cutaneous Lupus

The objective is to investigate the role of clinically significant antiphospholipid antibodies (aPL) in a cohort of systemic lupus erythematosus (SLE) patients. All SLE patients followed for at least 5 years and with available aPL profile at the beginning of the follow-up in our center were studied. Clinically significant aPL were defined as: positive lupus anticoagulant test, anti-cardiolipin and/or anti- β2Glycoprotein I IgG/IgM &gt;99<sup>th</sup> percentile on two or more occasions at least 12 weeks apart. Patients with and without clinically significant aPL were compared by univariate (Chi square or Fisher’s exact test for categorical variables and Student’s <em>t</em> or Mann-Whitney test for continuous variables) and multivariate analysis (logistic regression analysis). P values &lt;0.05 were considered significant. Among 317 SLE patients studied, 117 (37%) had a clinically significant aPL profile at baseline. Such patients showed at univariate analysis an increased prevalence of deep venous thrombosis, pulmonary embolism, cardiac valvular disease, cognitive dysfunction and antiphospholipid syndrome (APS), but a reduced prevalence of acute cutaneous lupus and anti-extractable nuclear antigens (ENA) when compared with patients without clinically significant aPL. Multivariate analysis confirmed the association between clinically significant aPL and reduced risk of acute cutaneous lupus [p=0.003, odds ratio (OR) 0.43] and ENA positivity (p&lt;0.001, OR 0.37), with increased risk of cardiac valvular disease (p=0.024, OR 3.1) and APS (p&lt;0.0001, OR 51.12). Triple positivity was the most frequent profile and was significantly associated to APS (p&lt;0.0001, OR 28.43). Our study showed that one third of SLE patients had clinically significant aPL, and that this is associated with an increased risk, especially for triple positive, of APS, and to a different clinical and serological pattern of disease even in the absence of APS.

Consultation with rheumatologist: debut of systemic lupus erythematosus

2021 ◽  
Vol 1 (11) ◽  
pp. 55-59
Author(s):  
T. N. Gavva ◽  
A. A. Pecherskikh ◽  
D. E. Gogolev ◽  
L. V. Teplova ◽  
Yu. S. Shklyaeva ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Diagnostic Criteria ◽  
Lupus Erythematosus ◽  
Antiphospholipid Antibodies ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Systemic Lupus ◽  
Clinical Criteria ◽  
American College Of Rheumatology ◽  
Rheumatological Diseases

Systemic lupus erythematosus (SLE) is one of the most complex rheumatological diseases, occurring with a variety of clinical forms and manifestations. The debuts and variants of the course of SLE can vary significantly, so it is called ‘chameleon disease’ or ‘the great imitator of diseases’. In 2019, a group of experts from the European Anti-Rheumatic League and the American College of Rheumatology developed the latest criteria for the diagnosis of systemic lupus erythematosus. A prerequisite for the diagnosis is a positive antinuclear factor in combination with the seven clinical criteria for SLE (constitutional, hematological, neuropsychiatric, skin‑mucosal, polyserositis, renal) and the three immunological signs (antiphospholipid antibodies, levels of complement and its fractions, SLE‑specific autoantibodies) The article describes a case of systemic lupus erythematosus, diagnosed in a patient who was admitted to the hospital with a directional diagnosis of ‘fever of unknown origin’. The diagnosis of systemic lupus erythematosus was established on the basis of seven clinical criteria and two immunological diagnostic criteria.

scholarly journals Frequency of Necessary Clinical and Laboratory Diagnostic Criteria for Systemic Lupus Erythematosus in the Presence of Active Cytomegalovirus and M. A. Epstein – Y. Barr Virus and Their Diagnostic Value

2020 ◽  
Vol 4 (32) ◽  
pp. 42-53
Author(s):  
S. Guta ◽  
◽  
O. Abrahamovych ◽  
U. Abrahamovych ◽  
L. Tsyhanyk ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Diagnostic Criteria ◽  
Lupus Erythematosus ◽  
Antiphospholipid Antibodies ◽  
Lupus Anticoagulant ◽  
Diagnostic Value ◽  
Cmv Infection ◽  
Systemic Lupus ◽  
Barr Virus ◽  
Laboratory Markers

Introduction. Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown etiology, in the origin and pathogenesis of which cytomegalovirus (CMV) and M. A. Epstein – Y. Barr virus (EBV) play an important role. There is a need to find in patients with SLE such clinical and laboratory markers identified from the obligatory diagnostic criteria of the disease, which would allow in such conditions to inform about the presence of this active viral infection. The aim of the study. To determine the frequency of necessary clinical and laboratory diagnostic criteria for systemic lupus erythematosus in the presence of active cytomegalovirus and M. A. Epstein – Y. Barr virus, their diagnostic value. Materials and methods. 120 patients with SLE were included in the study. To diagnose CMV and EBV infection, antibodies to viruses and their deoxyribonucleic acid (DNA) were detected. All patients were divided into four groups, namely: with active CMV infection, active EBV, active CMV and EBV and without active CMV and EBV. Results. We found that patients with SLE and active CMV infection are significantly more likely than patients with SLE without active infections to have arthritis, psychosis, leukopenia, increased antibody titers to double-stranded DNA (anti-DNA) and antiphospholipid antibodies; and arthritis, psychosis, leukopenia and increased titer of antiphospholipid antibodies have the highest diagnostic value for the diagnosis of active CMV infection. The patients with SLE and active EBV infection significantly more often than in patients without active infections to have photosensitization, ulcers of mucous membranes, thrombocytopenia and increased titer of anti-DNA, and photosensitization, mucosal ulcers and thrombocytopenia have the highest diagnostic value for the diagnosis of active EBV infection. The patients with SLE and a combination of active CMV and EBV are significantly more likely than patients with SLE and without active infections to have “butterfly” erythema, lymphopenia, detection of lupus anticoagulant and increased titer of antinuclear antibodies, and “butterfly” erythema, lymphopenia and the appearance of lupus anticoagulant have the highest diagnostic value of active CMV and EBV. Conclusions. In patients with systemic lupus erythematosus and active cytomegalovirus infection, among the necessarily diagnostic criteria for systemic lupus erythematosus clinical and laboratory markers are significantly more often arthritis, psychosis, leukopenia, increased antibody titer to double-stranded deoxyribonucleic acid and antiphospholipid antibodies than in patients with systemic lupus erythematosus without these active infections. In patients with active M. A. Epstein – Y. Barr virus there are significantly more often photosensitization, ulcers of mucous membranes, thrombocytopenia and increased titer of antibodies to double-stranded deoxyribonucleic acid than in patients with systemic lupus erythematosus without these active infections.. In patients with a combination of active cytomegalovirus and M. A. Epstein – Y. Barr virus are significantly more often “butterfly” erythema, lymphopenia, the appearance of lupus anticoagulant and increased titer of antinuclear antibodies than in patients with systemic lupus erythematosus without these active infections. Such clinical and laboratory markers as arthritis, or psychosis, or leukopenia or increase in the titer of antiphospholipid antibodies allow to suspect patients with the presence of active cytomegalovirus; photosensitization, or ulcers of mucous membranes, or thrombocytopenia – active M. A. Epstein – Y. Barr virus; “butterfly” erythema, or lymphopenia, or the appearance of lupus anticoagulant – a combination of active cytomegalovirus and M. A. Epstein – Y. Barr virus, the final verification of which requires the use of direct serological tests.

1278: The Role of Diagnostic Criteria of Obstruction in Patients with High Grade Cystocele: Correlation to Subjective Symptoms

2007 ◽  
Vol 177 (4S) ◽  
pp. 421-421
Author(s):  
Veronica Triaca ◽  
Christian O. Twiss ◽  
Ramdev Konijeti ◽  
Larissa V. Rodriguez ◽  
Shlomo Raz
Keyword(s):  
Diagnostic Criteria ◽  
High Grade ◽  
Subjective Symptoms

Autoantibodies to Phospholipids and to the Coagulation Proteins in AIDS

1997 ◽  
Vol 77 (05) ◽  
pp. 0856-0861 ◽  
Author(s):  
N Abuaf ◽  
S Laperche ◽  
B Rajoely ◽  
R Carsique ◽  
A Deschamps ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Antiphospholipid Antibodies ◽  
Blood Donors ◽  
Heterogeneous Mixture ◽  
Systemic Lupus ◽  
Hematological Disorders ◽  
False Positive Test ◽  
Glycoprotein I ◽  
Coagulation Proteins ◽  
Hiv 1

SummaryIn HIV-1 infection, an increased prevalence of anticardiolipin autoantibodies (aCL) and lupus anticoagulant (LA) has been described. In order to see if these antibodies are isolated or, like in autoimmune diseases, associated with hematological disorders and with antibodies to other phospholipids and to proteins of coagulation, we investigated 3 groups of patients: 1. 342 HIV-1 infected patients, 2. 145 control patients including 61 systemic lupus erythematosus (SLE) patients, 58 patients with a connective tissue disease, 15 patients with stroke, 11 patients with syphilis and 3.100 blood donors. In HIV-1 infection antiprothrombin (aPrT) antibodies were present in 25% of patients, the prevalence of antiphosphatidylcholine antibodies (aPC) (50%) was almost as high as aCL (64%), and 39% had both antibodies. Absorption on liposomes of the latter revealed an heterogeneous mixture of aCL and aPC or cross-reacting antibodies. In contrast with SLE, anti-β2-glycoprotein I (4%), LA (1%), biological false positive test for syphilis (0.3%), thrombosis (p <0.001) were uncommon. In HIV-1 infection, antiphospholipid antibodies do not associate with features linked to them in SLE or syphilis.

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