TY - JOUR
T1 - Anti-β2-glycoprotein I
T2 - Prevalence, clinical correlations, and importance of persistent positivity in patients with antiphospholipid syndrome and systemic lupus erythematosus
AU - Danowski, Adriana
AU - Kickler, Thomas S.
AU - Petri, Michelle
N1 - Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2006/9
Y1 - 2006/9
N2 - Objective. Antibodies to β2-glycoprotein I (anti-β2-GPI) are found in a large percentage of patients with primary or secondary antiphospholipid syndrome (APS). Our aim was to identify the prevalence and clinical correlation of these antibodies in patients with APS and systemic lupus erythematosus (SLE), in comparison to anticardiolipin (aCL) and the lupus anticoagulant (LAC). We investigated whether serial samples improve clinical utility. Methods. Serum samples for anti-β2-GPI (IgG, IgM, IgA), aCL (IgG, IgM, IgA), and LAC (by dilute Russell viper venom time; RVVT) were collected from 418 consecutive patients with SLE or APS between October 2002 and March 2003. Clinical and serologic data of these patients were analyzed. Results. A total of 185 (44.5%) patients were positive for anti-β2-GPI, 55.3% were positive for aCL, and 31.1% for LAC. Anti-β2-GPI was more common in Caucasians than in African Americans (p = 0.098). IgM and IgA were the most frequent isotypes of anti-β2-GPI. aCL and anti-β2-GPI were highly associated (p < 0.0001 to p = 0.0177, depending on isotype). A positive association was found between the presence of the LAC by dilute RVVT and anti-β2-GPI IgG (p < 0.0001), IgM (p < 0.0001), and IgA (p = 0.0002) antibodies. Persistent positivity increased the association of venous and arterial thrombosis with anti-β2-GPI (IgG and IgM isotypes). Pregnancy loss, seizures, and migraines were not associated with anti-β2-GPI. IgA anti-β2-GPI was not significantly associated with any manifestation of APS. Conclusion. The prevalence of anti-β2-GPI IgM and IgA was very high in our population. Measurement of anti-β2-GPI IgG is clinically useful in identifying patients with SLE at higher risk for venous and arterial thrombosis. Persistent positivity increased the association of IgG anti-β2-GPI with venous thrombosis and anti-β2- GPI IgM with arterial thrombosis. IgA anti-β2-GPI was not significantly associated with APS manifestations.
AB - Objective. Antibodies to β2-glycoprotein I (anti-β2-GPI) are found in a large percentage of patients with primary or secondary antiphospholipid syndrome (APS). Our aim was to identify the prevalence and clinical correlation of these antibodies in patients with APS and systemic lupus erythematosus (SLE), in comparison to anticardiolipin (aCL) and the lupus anticoagulant (LAC). We investigated whether serial samples improve clinical utility. Methods. Serum samples for anti-β2-GPI (IgG, IgM, IgA), aCL (IgG, IgM, IgA), and LAC (by dilute Russell viper venom time; RVVT) were collected from 418 consecutive patients with SLE or APS between October 2002 and March 2003. Clinical and serologic data of these patients were analyzed. Results. A total of 185 (44.5%) patients were positive for anti-β2-GPI, 55.3% were positive for aCL, and 31.1% for LAC. Anti-β2-GPI was more common in Caucasians than in African Americans (p = 0.098). IgM and IgA were the most frequent isotypes of anti-β2-GPI. aCL and anti-β2-GPI were highly associated (p < 0.0001 to p = 0.0177, depending on isotype). A positive association was found between the presence of the LAC by dilute RVVT and anti-β2-GPI IgG (p < 0.0001), IgM (p < 0.0001), and IgA (p = 0.0002) antibodies. Persistent positivity increased the association of venous and arterial thrombosis with anti-β2-GPI (IgG and IgM isotypes). Pregnancy loss, seizures, and migraines were not associated with anti-β2-GPI. IgA anti-β2-GPI was not significantly associated with any manifestation of APS. Conclusion. The prevalence of anti-β2-GPI IgM and IgA was very high in our population. Measurement of anti-β2-GPI IgG is clinically useful in identifying patients with SLE at higher risk for venous and arterial thrombosis. Persistent positivity increased the association of IgG anti-β2-GPI with venous thrombosis and anti-β2- GPI IgM with arterial thrombosis. IgA anti-β2-GPI was not significantly associated with APS manifestations.
KW - Antiphospholipid syndrome
KW - Systemic lupus erythematosus
KW - Thrombosis
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M3 - Article
C2 - 16960938
AN - SCOPUS:33748550680
SN - 0315-162X
VL - 33
SP - 1775
EP - 1779
JO - Journal of Rheumatology
JF - Journal of Rheumatology
IS - 9
ER -