Background Anticardiolipin antibodies (aCL) are quite common findings in patients with systemic rheumatic diseases. However, clinical significance of aCL presence still remains not completely clear despite some very well known clinical associations.
Objectives The purpose of our study was to evaluate clinical significance of aCL in our patients with systemic rheumatic diseases.
Methods We examined 242 pts who suffered from rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and systemic sclerosis (SS) and underwent treatment in Kaunas University of Medicine Rheumatology department. The control pts group (107 pts) was formed of healthy blood donors and pts without presence of any signs of rheumatic or immune disease. There were 216 (89%) women and 26 (11%) men aged 10 to 80 years (mean 51.4 ± 14.6 yr.) in study group. RA group consisted of 158 (65.3%) pts, SLE – of 53 (21.9%) pts, and SS group of 31 (12.8%) pts. Diagnosis was evaluated according to standard American Rheumatology Association criteria. Enzyme immunoassay test to detect aCL IgG was performed in all pts.
Results Presence of aCL IgG was found in 38 (15.7%) pts out of 242 pts in the study group and in 6 (5.6%) control group pts. The incidence of aCL IgG was 30.2% in SLE pts, 29% in SS pts, and 8.2% in RA pts. There was significant difference in aCL IgG frequency between study pts and control groups, p = 0.009, and between SLE and SS pts and control pts as well (p = 0.000014 and 0.0002, respectively). However, there was similar aCL IgG incidence in RA and control pts.
Age of pts with positive enzyme immunoassay (EIA) test was significantly lower as compared with negative EIA test pts (mean age 45.8 ± 15.8 yr. and 52.5 ± 14.1 yr., respectively, p = 0.009). However, this difference appeared to be significant in SLE pts only (p = 0.02).
There was no significant difference in aCL IgG incidence in separate subsets of pts either in respect to sex, or disease activity, course, or duration. In fact, some clinical manifestations were strongly associated with the presence of aCL IgG. There was significant difference in incidence of livedo reticularis, subacute vein thrombosis, and thrombocytopenia between pts with positive and negative EIA test (p = 0.015, 0.0066, 0.001, respectively).
The diagnosis of secondary antiphospholipid antibody syndrome (APS) was confirmed in 15 (6.2%) pts. There were 11 (20.7%) pts in SLE group, 2 (6.4%) pts in SS group, and 2 (1.3%) pts in RA group with this condition. The majority of those pts were aCL IgG – positive (p = 0,0001, as compared with aCL IgG – negative APS pts).
Conclusion 1) Presence of aCL IgG was associated with some clinical manifestations such as livedo reticularis, subacute vein thrombosis, and thrombocytopenia, and antiphospholipid antibody syndrome in pts with systemic rheumatic diseases, 2) There was no association found between presence of aCL IgG and pts sex, disease activity, course, or duration.
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