Prevalence and associations of anti-phosphatidylserine/prothrombin antibodies with clinical phenotypes in patients with primary antiphospholipid syndrome aPS/PT antibodies in primary antiphospholipid syndrome

被引:17
作者
Nunez-Alvarez, Carlos A. [1 ]
Hernandez-Molina, Gabriela [1 ]
Bermudez-Bermejo, Paola [1 ]
Zamora-Legoff, Victor [1 ]
Hernandez-Ramirez, Diego F. [1 ]
Olivares-Martinez, Elizabeth [1 ]
Cabral, Antonio R. [2 ]
机构
[1] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Dept Immunol & Rheumatol, Vasco Quiroga 15,Secc 16 Belisario Dominguez, Mexico City 14080, DF, Mexico
[2] Univ Ottawa, Ottawa Hosp, Dept Med, Div Rheumatol, 1967 Riverside Dr, Ottawa, ON K1H 7W9, Canada
关键词
aPS/PT antibodies; Thrombosis; Thrombocytopenia; Anti-phospholipid syndrome; aPL antibodies; ANTIPHOSPHATIDYLSERINE/PROTHROMBIN ANTIBODIES; CLASSIFICATION CRITERIA; PROTHROMBIN; MARKERS; UPDATE;
D O I
10.1016/j.thromres.2018.12.023
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: The clinical significance of anti-phosphatidylserine/prothrombin (aPS/PT) in antiphospholipid syndrome (APS) is still controversial. We assessed the prevalence of aPS/PT antibodies, their association with other anti-phospholipid antibodies (aPL) and with different APS clinical phenotypes. Methods: We included 95 primary APS patients according to the Sydney classification criteria, and patients with thrombocytopenia and/or hemolytic anemia who also fulfilled the serological APS criteria. We tested aCL, anti-beta 2GP-I and aPS/PT antibodies (both IgG and IgM isotypes) and lupus anticoagulant (LA). We used chi 2 test, Spearman's correlation coefficient, Mann-Whitney U test and logistic regression. Results: Seventy-seven percent of patients had thrombosis, 50% hematologic involvement and 25% obstetric events (non-exclusive groups). Twenty patients had only hematologic features. The prevalence of IgG and IgM aPS/PT antibodies was 61% and 60%, respectively. Patients with LA+ had a higher prevalence and higher titers of IgG and IgM aPS/PT antibodies. aPS/PT antibodies correlated with aPL antibodies including LA. IgG aPS/PT antibodies were associated with thrombosis (OR 8.6 [95% CI 2.13-33.8, p = 0.002]) and pure hematologic features (OR 0.2, CI 95% 0.05-0.97, p = 0.004). IgM anti-beta 2GP-I antibodies conferred high risk for both hematologic (OR 7.9, 95% CI 1.88-34.61, p = 0.006) and thrombotic involvement (OR 7.4, 95% CI 1.76-31.12, p = 0.006). Conclusions: aPS/PT antibodies were highly prevalent and correlated with other aPL antibodies. IgG aPTS/PT conferred a high risk for thrombosis, but not for pure hematologic involvement. aPS/PT antibodies may be a useful serological tool in the diagnosis and phenotypic characterization of APS patients.
引用
收藏
页码:141 / 147
页数:7
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