Antibody to Cardiolipin as a Predictor of Fetal Distress or Death in Pregnant Patients with Systemic Lupus Erythematosus

Lockshin, Michael D.; Druzin, Maurice L.; Goei, Stephanie; Qamar, Tasneem; Magid, Margret S.; Jovanovič, Lois; Ferenc, Michael

doi:10.1097/00006254-198605000-00014

Cited by 87 publications

(114 citation statements)

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“…The mechanism for fetal wastage in lupus is probably multifactorial, with contributions from disease activity, immunosuppressive therapy, and possibly ly mphocytotoxic antibodies, immune complexes, the lupus anticoagulant, and anticardiolipin antibodies (3,4,14,15). On the basis of a series of uncontrolled studies, an association between atypical lupus, LAC, ACL, antibody, and recurrent abortion has been proposed (7,16).…”

Section: Discussionmentioning

confidence: 99%

“…The LAC may play a role in fetal loss through uteroplacental thrombosis (26). The impression is given in the literature that there is a clearly established relationship between antiphospholipid antibodies and recurrent abortions, and furthermore, that treatment may lead to successful pregnancy, whereas lack of treatment almost uniformly results in unsuccessful pregnancy (3,7,8,17). Series of lupus patients with antiphospholipid antibodies and recurrent abortions have been described (3,4,7,15), but a similarly strong association between LAC and recurrent abortion has been believed to exist in women without clinical lupus To ensure detection of relevant antiphospholipid antibodies, we employed 3 assays, APTT, RVVT (a coagulation assay for LAC), and ACL, in our study.…”

Section: Discussionmentioning

confidence: 99%

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Antinuclear antibody, lupus anticoagulant, and anticardiolipin antibody in women with idiopathic habitual abortion. A controlled, prospective study of forty‐four women

Petri

Golbus

Anderson

et al. 1987

Arthritis & Rheumatism

164

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In a controlled, prospective study of 44 consecutive women with idiopathic habitual abortion, only 5% had symptoms of rheumatic disease. Patients did not differ from control subjects in the frequency of positive results on tests for antinuclear antibody or anti-doublestranded DNA. Levels of C3 and C4 were higher in the habitual aborters. No patients had anti-Ro. The antiphospholipid antibody results were analyzed using 2 methods: the frequency of antiphospholipid antibodies was 9% by lupus anticoagulant using the Russell viper venom time (95% confidehce interval 22-2.5). and 11% by anticardiolipin antibody assay (95% confidence interval 25-3.7), which was not significantly different from that in control subjects. However, the mean levels in the aborters (although within the normal range) were Submitted for publication August 18, 1986; accepted in revised form January 7, 1987. significantly higher than those in control subjects for anti-double-stranded DNA (P = 0.004), lupus anticoagulant (by Russell viper venom time; P = 0.09), and anticardiolipin antibody (P = 0.0007), when examined by multiple linear regression analysis corrected for age and concurrent pregnancy. Of the 3 patients with antiphospholipid antibodies and subsequent successful pregnancies, only 1 was treated with prednisone and aspirin. We conclude that, in the majority of women, subclinical lupus, anti-Ro, the lupus anticoagulant, and anticardiolipin antibodies are not associated with idiopathic habitual abortion.Women with systemic lupus erythematosus (SLE) have an increased frequency of spontaneous abortions (1-4), but most women who habitually abort do not meet criteria for the diagnosis of SLE (5,6). No previous study has examined the frequency of laboratory findings that are generally associated with lupus (antinuclear antibodies [ANA], anti-Ro, lupus anticoagulant [LAC], and anticardiolipin [ACL] antibody among women with idiopathic habitual abortion ( 3 or more consecutive spontaneous abortions) compared with the frequency among normal controls. In the absence of controlled trials, it has been proposed that ANA, anti-Ro, LAC, and ACL, antibodies play a causal role in idiopathic habitual abortion and that treatment of the problems indicated by these laboratory findings may be necessary (7-10).We now report the frequency of ANA, antidouble-stranded DNA (dsDNA), anti-Sm, anti-RNP, anticentromere antibody, anti-Ro, anti-La, cornple-

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Antinuclear antibody, lupus anticoagulant, and anticardiolipin antibody in women with idiopathic habitual abortion. A controlled, prospective study of forty‐four women

Petri

Golbus

Anderson

et al. 1987

Arthritis & Rheumatism

164

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“…The appearance of the autoantibodies is known to be associated with thromboembolic manifestations such as cerebral or myocardial infarctions, intrauterine fetal death due to placental infarction, and neurological defects [2,3].…”

Section: Introductionmentioning

confidence: 99%

Measurement of anticardiolipin antibodies by ELISA using β2-glycoprotein I (β2-GPI) in systemic sclerosis

Ihn

Sato

Fujimoto

et al. 1996

Clinical and Experimental Immunology

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SUMMARYIn order to determine the prevalence and clinical significance of¯2-GPI-dependent anticardiolipin antibodies (¯2-GPI/aCL) in patients with systemic sclerosis (SSc), serum samples from 80 patients with SSc, 20 patients with systemic lupus erythematosus (SLE), and 120 healthy control subjects were examined by ELISA using purified¯2-GPI. IgG isotype¯2-GPI/aCL was present in eight of 80 patients with SSc (10%), and the presence of¯2-GPI/aCL IgG was significantly correlated with the presence of isolated pulmonary hypertension (PH). Furthermore, levels of¯2-GPI/aCL IgG were significantly correlated with levels of mean pulmonary arterial pressure. These data suggest that IgG isotype¯2-GPI/ aCL might be a serological indicator of the severity of PH in patients with SSc.

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“…Patients with high titers of aPL are prone to a variety of thrombotic episodes and to fetal loss (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Antiphospholipid antibodies can be detected by lupus anticoagulant (LAC) assay or by enzyme immunoassays (EIA) against phospholipids.…”

mentioning

confidence: 99%

Antibodies to β₂‐glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus

Tsutsumi

Matsuura

Ichikawa

et al. 1996

Arthritis & Rheumatism

212

109

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Objective. To investigate whether anticardiolipin antibodies (aCL) in patients with systemic lupus erythematosus (SLE) bind to β2‐glycoprotein I (β2GPI), and to search for a relationship between the presence of IgG and/or IgM anti‐β2GPI antibody and clinical manifestations in SLE patients. Methods. IgG and IgM anti‐β2GPI in 308 Japanese SLE patients were measured using phospholipid‐independent enzyme immunoassays. Relationships to clinical histories and to various laboratory data were examined. Results. The values of anti‐β2GPI and aCL, as measured by conventional enzyme immunoassay, showed a strong correlation, but the anti‐β2GPI assay was more useful in distinguishing β2GPI‐dependent aCL from β2GPI‐independent aCL. The presence of IgG anti‐β2GPI was associated with an increased frequency of a history of thrombosis. Comparisons of various laboratory data suggested that the titer of anti‐β2GPI may fluctuate with disease activity. Conclusion. The results suggest that pathogenic aCL is directed against structurally altered β2GPI and that enzyme immunoassay for anti‐β2GPI may prove useful in evaluating the risk of thrombosis and monitoring the clinical course in patients with SLE.

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Antibody to Cardiolipin as a Predictor of Fetal Distress or Death in Pregnant Patients with Systemic Lupus Erythematosus

Cited by 87 publications

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Antinuclear antibody, lupus anticoagulant, and anticardiolipin antibody in women with idiopathic habitual abortion. A controlled, prospective study of forty‐four women

Antinuclear antibody, lupus anticoagulant, and anticardiolipin antibody in women with idiopathic habitual abortion. A controlled, prospective study of forty‐four women

Measurement of anticardiolipin antibodies by ELISA using β2-glycoprotein I (β2-GPI) in systemic sclerosis

Antibodies to β₂‐glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus

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Antibody to Cardiolipin as a Predictor of Fetal Distress or Death in Pregnant Patients with Systemic Lupus Erythematosus

Cited by 87 publications

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Antinuclear antibody, lupus anticoagulant, and anticardiolipin antibody in women with idiopathic habitual abortion. A controlled, prospective study of forty‐four women

Antinuclear antibody, lupus anticoagulant, and anticardiolipin antibody in women with idiopathic habitual abortion. A controlled, prospective study of forty‐four women

Measurement of anticardiolipin antibodies by ELISA using β2-glycoprotein I (β2-GPI) in systemic sclerosis

Antibodies to β2‐glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus

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Antibodies to β₂‐glycoprotein I and clinical manifestations in patients with systemic lupus erythematosus