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FRI0176 Antibodies to cardiolipin and b2gpi in the group of women?s population with the history of recurrent spontaneous abortions
  1. YV Ershova,
  2. AA Baranov,
  3. NY Karpov,
  4. SE Aleksandrov,
  5. SY Nestuley,
  6. NE Abaytova,
  7. DL Guriev,
  8. VL Krylov
  1. Internal Medicine, Medical Academy, Yaroslavl, Russia

Abstract

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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