Objectives Antiphospholipid syndrome (APS) is frequently associated with systemic lupus erythematosus (SLE). In addition to an increased thromboembolic risk, it may alter the disease course of SLE. Our aim was to study the impact of secondary antiphospholipid syndrome and antiphospholipid antibody (APA) positivity on the clinical presentation of SLE.
Methods Data of 224 SLE patients (204 females, average age: 49 /20-92/ years) were analised retrospectively. Various SLE and APS related clinical and laboratory features were compared between patients without APA (n=119) and those with APA-positivity (n=105). Of these 105 APA-positive patients, 53 fulfilled the criteria for APS. Data on SLE+APS patients were also compared with those on SLE patients without APA-positivity. Central nervous system, cardiac, pulmonary and renal symptoms were considered major organ manifestations.
Results Significantly higher proportion of the APA-positive versus APA-negative SLE patients developed thromboembolic events, Coombs-positive haemolytic anaemia, thrombocytopenia and endocarditis. In addition, when APS complicated SLE, several non-thromboembolic symptoms occurred more often, than in the absence of APS: pleuritis, interstitial lung disease, myocarditis, nephritis and organic brain syndrome. The total number of major organ manifestations (1,2 vs 0,5) and also the sum of the organ manifestations ever occurred in an individual patient (8,1 vs 6,9) were higher in the SLE+APS patients than in those without APA (p<0.05). In the presence of secondary APS, SLE patients required more frequently iv. corticosteroid, iv. cyclophosphamide and azathioprine threatment, than the non-APA patients (p<0,05).
Conclusions The SLE patients with APA positivity or with secondary APS have a higher risk to develop non-thromboembolic disease manifestations in addition to the APA-related symptoms. Moreover, the SLE+APS patients have a predisposition to more severe SLE-manifestations, with the necessity of powerful immunosuppressive therapies.
Disclosure of Interest None Declared
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