Profiling of non-criteria antiphospholipid antibodies in patients with SLE: differentiation of thrombotic SLE patients and risk of recurrence of thrombosis

Lupus ◽  
2020 ◽  
Vol 29 (5) ◽  
pp. 490-498
Author(s):  
O Tkachenko ◽  
S Lapin ◽  
A Mazing ◽  
V Emanuel ◽  
E Belolipetskaia ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Deep Vein Thrombosis ◽  
Confidence Interval ◽  
Lupus Erythematosus ◽  
Antiphospholipid Antibodies ◽  
Odds Ratio ◽  
Arterial Thrombosis ◽  
Systemic Lupus ◽  
Vein Thrombosis ◽  
Deep Vein

To reveal the clinical significance of criteria and non-criteria antiphospholipid antibodies detected by line immunoassay in comparison with ELISA, systemic lupus erythematosus patients with and without thrombotic events were investigated. Thus, 107 systemic lupus erythematosus patients (48% with deep vein thrombosis or/and arterial thrombosis) and 120 healthy donors were enrolled. Serum antiphospholipid antibodies were detected by ELISA (Orgentec Diagnostika, Germany) and line immunoassay (GA Generic Assays, Germany). Lupus anticoagulant and IgG to cardiolipin and β2GPI but not IgM as well as triple positivity by ELISA and line immunoassay were linked with thrombosis in systemic lupus erythematosus. IgG to phosphatidylinositol and phosphatidylserine by line immunoassay showed significantly higher levels in systemic lupus erythematosus with deep vein thrombosis/arterial thrombosis than without and were independent risk factors for deep vein thrombosis (odds ratio 3.9, 95% confidence interval 1.1, 13.2) and arterial thrombosis (odds ratio 5.1, 95% confidence interval 1.3, 19.8) as well as thrombosis (odds ratio 3.6, 95% confidence interval 1.1, 11.3) and recurrence thereof (odds ratio 6.9, 95% confidence interval 2.1, 22.6), respectively. The occurrence of >4 IgG antiphospholipid antibodies by line immunoassay was an independent risk factor for thrombosis (odds ratio 10.9, 95% confidence interval 1.2, 101.5), arterial thrombosis (odds ratio 14.6, 95% confidence interval 2.5, 86.3), deep vein thrombosis (odds ratio 5.8, 95% confidence interval 1.0, 32.4) and recurrence of thrombosis (odds ratio 35.9, 95% confidence interval 3.8, 342.8). Line immunoassay is a promising multiplex test for the simultaneous detection of criteria and non-criteria antiphospholipid antibodies. Profiling of antiphospholipid antibodies by line immunoassay can differentiate systemic lupus erythematosus patients with thrombosis from systemic lupus erythematosus patients without and assess the risk for thrombosis and recurrence thereof.

scholarly journals From TTP to Glomerulonephritis: A Lifetime of Lupus

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Fadi Kharouf ◽  
Sigal Shahar ◽  
Yoav Hershkovitz ◽  
Alaa Shaheen ◽  
Areej Bayatra ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Deep Vein Thrombosis ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Disease Course ◽  
Systemic Lupus ◽  
Thrombocytopenic Purpura ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Excellent Clinical Outcome

We report the case of a 56-year-old male patient, who over two decades, sequentially presented with a combination of clinical manifestations. These included thrombotic thrombocytopenic purpura (TTP), right leg deep vein thrombosis (DVT), and eventually constitutional symptoms, arthralgia, diffuse lymphadenopathy, pancytopenia, skin rash, pericarditis, and glomerulonephritis. Serologic tests and renal pathology uncovered a diagnosis of systemic lupus erythematosus (SLE), and immunosuppressive therapy was initiated. Soon after, the patient developed striking cytomegalovirus (CMV) viremia, requiring prolonged antiviral therapy and reduction of immunosuppression. Finally, an acute embolic stroke complicated the disease course. Prompt interventions allowed an excellent clinical outcome.

Recurrent antiphospholipid-related deep vein thrombosis as presenting manifestation of systemic lupus erythematosus

2000 ◽  
Vol 159 (3) ◽  
pp. 211-214 ◽  
Author(s):  
Marco Gattorno ◽  
Angelo Claudio Molinari ◽  
Antonella Buoncompagni ◽  
Maura Acquila ◽  
Stefano Amato ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Deep Vein Thrombosis ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Vein Thrombosis ◽  
Deep Vein

Factor V Leiden, Antiphospholipid Antibodies and Thrombosis in Systemic Lupus Erythematosus

1996 ◽  
Vol 76 (04) ◽  
pp. 514-517 ◽  
Author(s):  
R Fijnheer ◽  
D A Horbach ◽  
R C J M Donders ◽  
H Vilé ◽  
E v Oort ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Venous Thrombosis ◽  
Lupus Erythematosus ◽  
Antiphospholipid Antibodies ◽  
Odds Ratio ◽  
Arterial Thrombosis ◽  
Lupus Anticoagulant ◽  
Factor V Leiden ◽  
Factor V ◽  
Systemic Lupus

SummaryThromboembolic complications are frequently observed in patients with systemic lupus erythematosus (SLE). Significant associations have been reported between these complications and the presence of antiphospholipid antibodies, notably the lupus anticoagulant and anti-cardiolipin antibodies. Factor V Leiden is a genetic disorder associated with an increased risk of venous thrombosis. We studied these factors in 173 patients with SLE in relation to both arterial and venous thrombosis. The frequency of factor V Leiden in SLE patients is comparable to that in the Dutch population (5%) and a risk factor for venous thrombosis (odds ratio 4.9; Cl 1.2-19.6), but not for arterial thrombosis. The lupus anticoagulant is a risk factor for both arterial thrombosis (odds ratio 7.1; Cl 2.9-17.4) and venous thrombosis (odds ratio 6.4; Cl 2.7-15.4). From multivariate analysis, both the lupus anticoagulant and factor V Leiden appeared independent risk factors for venous thrombosis.

scholarly journals Primary Antiphospholipid Syndrome (APS) and Systemic Lupus Erythematosus (SLE) with Multiple Deep Vein Thrombosis- Case Report

2020 ◽  
Vol 8 (10) ◽  
pp. 882-885
Author(s):  
Dr. Krishna Kumar Dhakchinamoorthi ◽  
Dr. Ann Mary Alex ◽  
Dr. Nikhil Cherian Sam ◽  
Dr. Jeevanantham R ◽  
Mohamed Sulaiman G ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Deep Vein Thrombosis ◽  
Case Report ◽  
Antiphospholipid Syndrome ◽  
Lupus Erythematosus ◽  
Primary Antiphospholipid Syndrome ◽  
Systemic Lupus ◽  
Vein Thrombosis ◽  
Deep Vein

scholarly journals Multifocal avascular osteonecrosis despite appropriate anticoagulation therapy in a patient with systemic lupus erythematosus and antiphospholipid syndrome

2018 ◽  
pp. bcr-2018-225532 ◽  
Author(s):  
Irene Cecchi ◽  
Laura Pérez Sánchez ◽  
Savino Sciascia ◽  
Dario Roccatello
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Hip Replacement ◽  
Antiphospholipid Antibodies ◽  
Anticoagulation Therapy ◽  
Vitamin K Antagonist ◽  
Systemic Lupus ◽  
Avascular Osteonecrosis ◽  
Vein Thrombosis ◽  
Deep Vein

Multifocal avascular osteonecrosis (AON) is a serious manifestation of systemic lupus erythematosus (SLE). Prothrombotic factors, especially antiphospholipid antibodies (aPL), have been associated with the development of AON; therefore, attenuating the procoagulant state while balancing the haemorrhagic risks might have a rationale when managing this condition. We report a case of a 37-year-old patient with SLE, treated with low doses of corticosteroids and immunosuppressive therapy, who was started on vitamin K antagonist following an episode of deep vein thrombosis while having persistent positivity for aPL. After 2 years, he presented with multifocal AON, involving both femurs and shoulders. The patient underwent a bilateral hip replacement, but despite appropriate anticoagulation therapy after 2 years, he developed another episode of AON at both distal epiphyses of the femurs and proximal epiphyses of the tibias. Multifocal AON should be suspected, especially in the presence of aPL positivity. Its aetiology is still unknown and is most likely multifactorial. Its management is challenging and requires combined approaches.

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