Objectives To determine the significance of IgG anticardiolipin antibodies (aCL) and IgG antibodies to b2GPI (anti-b2GPI) in the group of women?s population with the history of recurrent spontaneous abortions.
Methods 58 women with one, two, three and more spontaneous abortions (mean age ? 29,9 ± 5,7 years) were examined. Three of them were observed out of pregnancy. In control groups 12 healthy female donors (mean age ? 29,7 ± 4,2 years) and 10 normal pregnant women (mean age? 23,2 ± 4,6 years) without history of any spontaneous abortions were included. IgG aCL and IgG anti-b2GPI were measured by ELISA.
Results The elevated levels of both autoantibodies were not noted in both control groups. In the main group in 17 (29,3%) of 58 patients (pts) IgG aCL or IgG anti-b2GPI were found. Elevated levels of IgG aCL only in 11 (64,7%) of 17 pts with antiphospholipid antibodies were noted respectively. Elevated level of IgG anti-b2GPI only wasn’t noted in any pts. Elevated level of IgG anti-b2GPI and IgG aCL together had 6 (35,3%) pts.
In the group with IgG aCL without IgG anti-b2GPI (n = 11): 1) the history of one or two spont.ab. had 6 (54,5%) pts, three and more spont.ab.? 5 (45,5%) pts (mean number? 2,2 ± 1,8); 2) the clinical manifestations of the antiphospholipid syndrome (APS) were noted in 8 (72,7%), among them: 1(12,5%) pts had definite APS, 4 (50%) pts ?probable APS and 3 (37,5%) pts ? dubious APS; 3) the clinical manifestations of APS, such as deep venous thrombosis had 2 (18,2%) pts, migraine ? 7 (63,6%) pts, thrombocytopenia ? 1 (9,1%) pts. The evidences of stroke, livedo reticularis and ulcers of extremities had no one; 4) titers of antibodies were low in 3 (27,3%), medium ? in 7 (63,6%) and high ? in 1 (9,1%) pts.
In the group with IgG aCL and IgG anti-b2GPI (n = 6): 1) the history of one or two spont.ab. had 2 (33,4%) pts, three and more spont.ab.? 4 (66,7%) pts (mean number ? 5,3 ± 4,2); 2) the clinical manifestations of APS were noted in 6 (100%) pts, among them: 4 (66,7%) had definite APS, 2 (33,3%)? probable APS and no one had dubious APS; 3) the clinical manifestations of APS, such as thrombosis (arterial and venous, deep and superior) had 2 (33,3%) pts, migraine?5 (83,3%), thrombocytopenia? 5 (83,3%), stroke ? 2 (33,3%), livedo reticularis? 4 (66,7%) and ulcers of extremities? 1 (16,7%) pts; 4) titers of both antibodies were medium and high.
Conclusion We found that IgG aCL and IgG anti-b2GPI, especially their combination is one of the most important tests for APS in the pregnant women?s population with the history of spontaneous abortions, especially among the women with habitual abortion; simultaneous production of both antibodies correlated with severity of clinical manifestations of APS. The discovery of IgG anti-b2GPI make the clinical manifestations of APS more severe.
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