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Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease, with higher prevalence in women. An incidence peak occurs during the reproductive years, suggesting that estradiol may play a role in the clinical presentation of SLE. Anticardiolipin antibodies (ACA) are associated with antiphospholipid antibody syndrome (APLS), but can be found in patients with SLE without APLS, and relate to cardiovascular risk and nephrite. Objective: This study aimed at assessing whether the presence of ACA is associated with hormonal changes in a sample of women with SLE. Methods: Forty-seven women diagnosed with SLE according to the American College of Rheumatology criteria, aged 30.8 ± 8.12 years, were evaluated. None was on hormonal contraception, and their SLE activity was estimated using the SLE Disease Activity Index (SLEDAI). Patients were stratifi ed, according to the presence or absence of ACA, and estradiol and prolactin levels were measured. Results: Nine (19.1%) of 47 patients were positive for ACA. No differences were found between groups concerning age, duration of disease, and SLEDAI. In contrast, the median estradiol level was lower in the ACA-positive group [46.8 (21.0-72.1) pg/mL] than in the ACA-negative group [122.3 (64.8-172.7) pg/mL, P = 0.004]. Conclusion: These results suggest, for the fi rst time, an inverse association between ACA and estradiol levels in premenopausal SLE patients. Considering that both lower endogenous estradiol levels and ACA positivity are related to atherosclerosis, our fi nding may be clinically relevant in predicting cardiovascular risk and/or APLS development in SLE.

There is strong evidence on influence of sexual hormones in the immunity and development of autoimmune diseases, including systemic lupus erythematosus (SLE), in which particularly the abnormalities observed during pregnancy could play a critical role on SLE manifestations during this period. Prolactin, a pituitary hormone with increased serum levels during pregnancy and puerperium, as well as its high molecular weight isoform, the macroprolactin, has been shown to be elevated in SLE, with correlation to disease activity. However, much about the mechanisms of this association is still unknown and more studies are necessary to further understand of the influence of hormonal alterations in SLE presentation and flare-up.