Update on anti-phospholipid antibodies in SLE: the Hopkins’ Lupus Cohort

Abstract

Anti-phospholipid antibodies are common in patients in the Hopkins’ Lupus Cohort: 47% have anti-cardiolipin, 32.5% anti-β₂-glycoprotein I and 26% lupus anticoagulant (by dRVVT confirmatory testing). Systemic lupus erythematosus patients with the lupus anticoagulant at baseline have a 50% chance of a deep venous thrombosis/pulmonary embolus in the next 20 years. Anti-phospholipid antibodies differ in their association with thrombosis: the lupus anticoagulant is most strongly associated with arterial and venous thrombosis and is the only anti-phospholipid antibody associated with myocardial infarction. Anti-phospholipid antibodies are not associated with atherosclerosis. Lupus (2010) 19, 419—423.

Keywords

anti-cardiolipin antibodies anti-phospholipid syndrome lupus anticoagulant

Get full access to this article

View all access options for this article.

References

Somers E. , Magder LS , Petri M. Antiphospholipid antibodies and incidence of venous thrombosis in a cohort of patients with systemic lupus erythematosus. J Rheumatol 2002; 29: 2531-2536.

Maksimowicz-McKinnon K. , Magder LS , Petri M. Predictors of carotid atherosclerosis in systemic lupus erythematosus. J Rheumatol 2006; 33: 2458-2463.

Kiani AN , Magder L. , Petri M. Coronary calcium in systemic lupus erythematosus is associated with traditional cardiovascular risk factors, but not with disease activity. J Rheumatol 2008; 35: 1300-1306.

Petri M. , Rheinschmidt M. , Whiting-O’Keefe Q. , Hellmann D. , Corash L. The frequency of lupus anticoagulant in systemic lupus erythematosus: a study of 60 consecutive patients by activated partial thromboplastin time, Russell viper venom time, and anti-cardiolipin antibody. Ann Int Med 1987; 106: 524-531.

Derksen Rhwm , Hasselaar P. , Blokzijl L. , Gmelig Meyling FHJ , de Groot PG Coagulation screen is more specific than the anticardiolipin antibody ELISA in defining a thrombotic subset of lupus patients. Ann Rheum Dis 1988 ; 47: 364-371.

Ginsberg JS , Wells PS , Brill-Edwards P. , et al. Anti-phospholipid antibodies and venous thromboembolism. Blood 1995; 86: 3685-3691.

Horbach DA , van Oort E. , Donders RC , Derksen RH , de Groot PG Lupus anticoagulant is the strongest risk factor for both venous and arterial thrombosis in patients with systemic lupus erythematosus. Comparison between different assays for the detection of antiphospholipid antibodies [see comments] . Thromb Haemost 1996; 76: 916-924.

Simioni P. , Prandoni P. , Zanon E. , et al. Deep venous thrombosis and lupus anticoagulant. A case-control study. Thromb Haemost 1996; 76: 187-189.

Wahl DG , Guillemin F. , de Maistre E. , Perret C. , Lecompte T. , Thibaut G. Risk for venous thrombosis related to anti-phospholipid antibodies in systemic lupus erythematosus-a meta-analysis. Lupus 1997; 6: 467-473.

10.

Miyakis S. , Lockshin MD , Atsumi T. , et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4: 295-306.

11.

Del Papa N. , Raschi E. , Catelli L. , et al. Endothelial cells as a target for anti-phospholipid antibodies: role of anti-beta 2 glycoprotein I antibodies . Am J Reprod Immunol 1997; 38: 212-217.

12.

Simantov R. , LaSala JM , Lo SK , et al. Activation of cultured vascular endothelial cells by antiphospholipid antibodies. J Clin Invest 1995; 96: 2211-2219.

13.

Branch DW , Rodgers GM Induction of endothelial cell tissue factor activity by sera from patients with antiphospholipid syndrome: a possible mechanism of thrombosis . Am J Obstet Gynecol 1993; 168: 206-210.