Prevalence of antiphospholipid antibodies in patients with fetal loss

Article Abstract:

Systemic lupus erythematosus and other autoimmune diseases are characterized by the presence of autoantibodies, or antibodies produced by the immune system against the body's own tissues. Patients with these rheumatic diseases who have antiphospholipid antibodies have a higher risk of thrombosis (clot formation), recurrent miscarriages, and late fetal death. Antiphospholipid antibodies are directed against particular lipids (fats) found in the membranes of particular cells and tissues. These antibodies have also been found in women who have repeat miscarriages, but are apparently healthy. The prevalence of antiphospholipid antibodies in women with fetal loss is not known and may vary from 3 to 50 percent. To better understand this issue, 102 healthy women with fetal loss were studied for the presence of antiphospholipid antibodies and for other autoantibodies. Results were compared with those from 102 healthy control subjects. Of the 102 women with a history of miscarriage, 6 had a lupus-like disease and 6 had a history of thrombosis. Antibodies against cardiolipin, a lipid found in the heart and other tissues, were identified in 21 percent of patients and 10 percent of controls, a significant difference. Another antiphospholipid antibody that interferes with blood clotting, lupus anticoagulant, was found in five percent of patients, all of whom had antibodies against cardiolipin, or anticardiolipin antibodies. Antiphospholipid antibodies were significantly more prevalent in the patients with lupus-like disease or a history of thrombosis than in patients with only fetal loss, and in fact, accounted for the differences between the two groups of 102 women. Antinuclear antibodies, which are directed against structures in cell nuclei, were found significantly more often in patients, chiefly those with thrombosis or lupus-like disease, and were correlated with the presence of antiphospholipid antibodies. The results indicate that women with recurrent fetal loss should not be screened for antiphospholipid antibodies unless they show signs of systemic disease or have a history of thrombosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Measurement, Miscarriage, Antiphospholipid antibodies, Antinuclear antibodies

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Risk factors for thrombosis in lupus patients

Article Abstract:

Systemic lupus erythematosus (SLE), a long-term inflammatory disease of connective tissue, affects the skin, joints, kidneys, nervous system, and mucous membranes. Patients with SLE have a protein factor called lupus anticoagulant, which prevents blood coagulation. Patients with lupus anticoagulant also have a high incidence of thrombosis or blood clot formation, fetal loss in pregnant women, and thrombocytopenia, a decrease in blood platelets, cells important in clotting. It is not clear whether the lupus anticoagulant is involved in the development of thrombosis. The relationships between lupus anticoagulant, thrombosis, and characteristics of the blood were evaluated in 74 patients with SLE or lupus-like disease. Results showed that lupus anticoagulant was strongly associated with a history of thrombosis. Anticardiolipin antibodies, proteins that specifically bind to and inactivate the compound cardiolipin, and thrombocytopenia were also related to a history of thrombosis and the presence of lupus anticoagulant. Total levels of protein S, a blood factor involved in the control of blood coagulation, was lower in patients with thrombosis and lupus anticoagulant. Prothrombin, another factor that is important in blood clot formation, was reduced in three patients with lupus anticoagulant but without thrombosis, suggesting that decreased levels of prothrombin protect patients with lupus anticoagulant against thrombosis. A prolonged bleeding time was associated with lupus anticoagulant but not thrombosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Thrombosis

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Fluctuations of anticardiolipin antibody levels in patients with systemic lupus erythematosus: a prospective study

Article Abstract:

Under abnormal conditions, the body's natural defense mechanism, the immune system, produces specialized proteins called autoantibodies that attack the body's tissues and natural elements in what is referred to as an autoimmune reaction. Systemic lupus erythematosus (SLE, or lupus), a condition characterized by long-term inflammation of the connective tissue and affecting various body sites, is thought to be an autoimmune disease. SLE patients produce autoantibodies to phospholipids or phosphate-containing fatty substances, such as cardiolipin. Anticardiolipin antibodies (ACAs) have been correlated with fetal loss, thrombosis (clot formation), and thrombocytopenia (a decrease in blood platelets important in blood clotting), giving rise to the ACA syndrome. The type and levels of ACA, disease activity, and treatment with prednisone were evaluated over a four-year period in 53 patients with lupus. ACA levels increased in some cases without the occurrence of the ACA syndrome, and were not related to prednisone treatment. The type of ACA (IgG or IgM) and their levels were altered among 22 patients given either low doses of prednisone or no treatment. ACA IgG was related to disease activity in 11 of 47 patients and in the whole group. ACA IgG was related to ACA syndrome during remission but not during moderate or severe disease activity. ACA IgM was related to disease activity in four of 47 patients, but was associated with the ACA syndrome during both the active and remission phases of SLE. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cardiolipin

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