Background Anticardiolipin (ACL) antibodies have been independently associated with high incidence of thrombotic diseases and pregnancy associated disorders in patients with systemic lupus erythematosus (SLE).
Objectives This study aims to assess influence of ACL antibodies in SLE and their association with clinical, biological and immunological features.
Methods A retrospective study of 246 patients with systemic lupus erythematous (revised ACR criteria) conduced in an internal medicine department over a period time of 14 years. Two groups were compared according to the positivity of ACL antibodies (group1: positive ACL/ group2: negative ACL).
Results ACL antibodies were positive in 48.8% of SLE patients (screened in 168 patients). This prevalence was similar in female and male. Poor general state at diagnosis was more frequent in the ACL positive group (55.7% vs 38.6%; p=0.02). The following data were comparable in the two groups: joint involvement (91.8% vs 90.8%; p=0.7), pericarditis (33.8% vs 37.8%; p=0.6) and pleural effusion (24.1% vs 29.5%; p=0.44). Alopecia (38.6% vs 27.9%; p=0.2), central nervous system involvement (12.5% vs 18.8%; p=) and peripheral neuropathy (6.4% vs 11.1%; p=) were more frequent in the group 2 without significant difference. Prevalence of lupus nephritis was more important in the group 1 (52.8% vs 38.8%; p=0.07). Thromboembolic complications: deep venous thrombosis (13.8% vs 11.9%; p=0.72) and pulmonary embolism (10.8% vs 7.1%; p=0.51) were more frequent in patients with ACL antibodies without significant difference. Obstetrical complications were more frequent in group 1 but differences were not statistically significant; spontaneous abortions (29.5% vs 20.4%; p=0.29), intra-uterin death (13.6% vs 9.3%; p=0.5), premature birth (6.8% vs 1.9%; p=0.3).
There were no associations between hematologic disorders and ACL antibodies; leucopenia (51.3% vs 39.5%; p=0.13) and), lymphopenia (81% vs 80.2%; p=0.9), anemia (77.2% vs 74.4; p=0.6) and thrombopenia (22.8% vs 23.5%; p=0.9) were comparable in the two groups. Frequencies of anti-ds DNA antibody and of antibodies to extractable nuclear antigens were similar in the two groups. Only anti-B2GP1 antibodies were significantly associated to ACL antibodies (51.3% vs 17.2%; p<0.001).
Conclusions ACL antibodies were found in 30–40% of patients with SLE, this is comparable to our group.
No significant associations of ACL antibodies.to thrombotic events or obstetrical complications were found in our patients
Disclosure of Interest None declared