Clinical Reviews in Allergy & Immunology

, Volume 32, Issue 2, pp 131–137

Clinical Thrombotic Manifestations in SLE Patients With and Without Antiphospholipid Antibodies: A 5-year Follow-up

  • Tunde Tarr
  • Gabriella Lakos
  • Harjit Pal Bhattoa
  • Pal Soltesz
  • Yehuda Shoenfeld
  • Gyula Szegedi
  • Emese Kiss
Article

DOI: 10.1007/s12016-007-0009-8

Cite this article as:
Tarr, T., Lakos, G., Bhattoa, H.P. et al. Clinic Rev Allerg Immunol (2007) 32: 131. doi:10.1007/s12016-007-0009-8

Abstract

Objective

To analyze the association of antiphospholipid antibodies (aPL) with the development of clinical thrombotic manifestations and to characterize the efficacy of anti-thrombotic therapies used.

Methods

272 systemic lupus erythematosus (SLE) patients participated in the study. Patient files and a cumulative database were used to collect patients’ medical histories. Anti-cardiolipin (aCL), anti-beta2-glycoprotein I (aβ2GPI) antibodies, and lupus anticoagulant (LAC) were measured according to international recommendations. New thrombotic events were registered during follow-up.

Results

The patients were prospectively studied for 5 years, of whom 107 were aPL negative (aPL− group). Criteria for antiphospholipid syndrome (APS) were fulfilled by 84 of 165 aPL-positive patients (APS+ group) indicating that SLE patients with aPL have around 50% risk to develop thrombotic complications. The aPL+ group (n = 81) consisted of aPL+ but APS− patients. LAC was the most common aPL (n = 27, 32.1%) in patients with APS. The cumulative presence of aPL further increased the prevalence of thrombotic events. During the follow-up period, aPL developed in 8 of 107 patients (7.5%) from the aPL− group, of whom 3 (2.8%) presented with thrombotic complications. Other types of aPL developed in 7 of 165 (4.2%) aPL+ patients within 5 years. New thrombotic events occurred in 3.7% of aPL+ (n = 3) and 8.3% (n = 7) of the APS group. During follow-up, 52 of 81 aPL+ patients received primary prophylaxis, and 1 (1.9%) had transient ischemic attack (TIA). In the non-treatment group, 2 (6.9%) had stroke. Seventy-nine of 84 of the APS patients received secondary prophylaxis, and myocardial infarction occurred in 2 patients (on cumarine therapy maintaining an international normalized ratio around 2.5–3.0), and 5 suffered a stroke/TIA (1 on aspirin and 4 on aspirin + cumarine).

Conclusion

The findings emphasize the importance of determining both aCL and aβ2GPI antibodies and LAC in SLE patients and the need for adequate anticoagulant therapy.

Keywords

SLE APS Follow-up LAC Primary prophylaxis 

Copyright information

© Humana Press Inc. 2007

Authors and Affiliations

  • Tunde Tarr
    • 1
  • Gabriella Lakos
    • 1
  • Harjit Pal Bhattoa
    • 2
  • Pal Soltesz
    • 1
  • Yehuda Shoenfeld
    • 3
  • Gyula Szegedi
    • 1
  • Emese Kiss
    • 1
    • 4
  1. 1.Third Department of Internal Medicine, Medical and Health Science CentreUniversity of DebrecenDebrecenHungary
  2. 2.Department of Biochemistry and Molecular Pathology, Medical and Health Science CentreUniversity of DebrecenDebrecenHungary
  3. 3.Center for Autoimmune Diseases, Department of Medicine B, Sheba Medical Center, Sackler Faculty of MedicineTel-Aviv UniversityTel-AvivIsrael
  4. 4.DebrecenHungary