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Clinical Thrombotic Manifestations in SLE Patients With and Without Antiphospholipid Antibodies: A 5-year Follow-up

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Abstract

Objective

To analyze the association of antiphospholipid antibodies (aPL) with the development of clinical thrombotic manifestations and to characterize the efficacy of anti-thrombotic therapies used.

Methods

272 systemic lupus erythematosus (SLE) patients participated in the study. Patient files and a cumulative database were used to collect patients’ medical histories. Anti-cardiolipin (aCL), anti-beta2-glycoprotein I (aβ2GPI) antibodies, and lupus anticoagulant (LAC) were measured according to international recommendations. New thrombotic events were registered during follow-up.

Results

The patients were prospectively studied for 5 years, of whom 107 were aPL negative (aPL− group). Criteria for antiphospholipid syndrome (APS) were fulfilled by 84 of 165 aPL-positive patients (APS+ group) indicating that SLE patients with aPL have around 50% risk to develop thrombotic complications. The aPL+ group (n = 81) consisted of aPL+ but APS− patients. LAC was the most common aPL (n = 27, 32.1%) in patients with APS. The cumulative presence of aPL further increased the prevalence of thrombotic events. During the follow-up period, aPL developed in 8 of 107 patients (7.5%) from the aPL− group, of whom 3 (2.8%) presented with thrombotic complications. Other types of aPL developed in 7 of 165 (4.2%) aPL+ patients within 5 years. New thrombotic events occurred in 3.7% of aPL+ (n = 3) and 8.3% (n = 7) of the APS group. During follow-up, 52 of 81 aPL+ patients received primary prophylaxis, and 1 (1.9%) had transient ischemic attack (TIA). In the non-treatment group, 2 (6.9%) had stroke. Seventy-nine of 84 of the APS patients received secondary prophylaxis, and myocardial infarction occurred in 2 patients (on cumarine therapy maintaining an international normalized ratio around 2.5–3.0), and 5 suffered a stroke/TIA (1 on aspirin and 4 on aspirin + cumarine).

Conclusion

The findings emphasize the importance of determining both aCL and aβ2GPI antibodies and LAC in SLE patients and the need for adequate anticoagulant therapy.

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Authors and Affiliations

  1. Third Department of Internal Medicine, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary

    Tunde Tarr, Gabriella Lakos, Pal Soltesz, Gyula Szegedi & Emese Kiss

  2. Department of Biochemistry and Molecular Pathology, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary

    Harjit Pal Bhattoa

  3. Center for Autoimmune Diseases, Department of Medicine B, Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Yehuda Shoenfeld

  4. Debrecen, 4032, Hungary

    Emese Kiss

Authors
  1. Tunde Tarr
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  2. Gabriella Lakos
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  3. Harjit Pal Bhattoa
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  4. Pal Soltesz
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  5. Yehuda Shoenfeld
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  6. Gyula Szegedi
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  7. Emese Kiss
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Correspondence to Emese Kiss.

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Tarr, T., Lakos, G., Bhattoa, H.P. et al. Clinical Thrombotic Manifestations in SLE Patients With and Without Antiphospholipid Antibodies: A 5-year Follow-up. Clinic Rev Allerg Immunol 32, 131–137 (2007). https://doi.org/10.1007/s12016-007-0009-8

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  • DOI: https://doi.org/10.1007/s12016-007-0009-8

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