Objectives Antiphospholipid syndrome (APS) patients suffer from various clinical manifestations with the presence of antiphospholipid antibodies (aPL). APS may manifest itself as a primary disease (PAPS) or as a secondary disease (SAPS), most commonly in the context of Systemic Lupus Erythemathosus (SLE)
Methods We analyzed 488 patients: 346 PAPS (70.9%) (77.7% female and 22.3% male) average age 44.1±13.0 years and 142 patients with secondary APS (SLE) patients (29.1%) (90.8% female and 9.2% male) average age 47.2±14.8 years. aPL analysis included analysis of aCL (IgG/IgM), β2GPI (IgG/IgM) and LA. aPL analysis included analysis of aCL (IgG/IgM), β2GPI (IgG/IgM) and LA. In all patients data considering cardiac, vascular, pulmonary, neurological, skin and hematological disorders were collected.
Results There was 30.8% aCL-IgG, 49.7% aCL-IgM, 31.4% β2GPI IgG, 40.4% β2GPI IgM and 54.0% LA positive PAPS patients. Among SAPS patients 57.9% were aCL-IgG, 61.4% aCL-IgM, 40.7% β2GPI IgG, 45.0% β2GPI IgM and 51.1% LA positive. We observed 56.3% with neurological, 23.0% patients with skin, 27.3% with cardiac, 20.8% with hematological and 15.2% with pulmonary disorders. 54.3% of patients had peripheral vascular thrombosis (arterial, venous or both) in PAPS and 70.4% SAPS patients with skin, 77.3% with neurological, 40.8% with cardiac, 64.8% with hematological and 12.0% with pulmonary disorders. 57.9% of SAPS patients had peripheral vascular thrombosis. Between SAPS and PAPS patients we observed highly statisticaly significant difference considering neurological (p=0.0001), cardiac (p=0.002), skin (p=0.0001) and hematological manifestations (p=0.0001) in favour of patients with SAPS.
Conclusions Patients with SAPS suffer more often from various clinical features comparing to patients PAPS. Additional autoimmune burden in those patients presented through aPL presence besides actual autoimmune disease pannel, could be an explanation.
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Stojanovich L, Markovic O, Marisavljevic D, Elezovic I, Ilijevski N and Stanisavljevic N. Influence of antiphospholipid antibody levels and type on thrombotic manifestations: results from the Serbian National cohort study. Lupus 2011;0: 1–8.
Acknowledgements This work was supported by research grant number 175041 for 2011-2014, issued by the Ministry of Science of the Republic of Serbia.
Disclosure of Interest None declared