Antiphospholipid antibodies and kidney involvement in patients with systemic sclerosis

Abstract

Antiphospholipid (aPL) antibodies are often detected in systemic autoimmune diseases. The aim of the study was to examine the correlation between the presence of aPL and certain markers of renal function in systemic sclerosis (SSc). Fifty patients (pts) with SSc were examined for the presence of antibodies to cardiolipin (aCL) and to anti-beta 2 glycoprotein I (a-B2GPI) in immunoglobulin M (IgM) and IgG class. Moreover, serum levels of creatinine, cystatin C, and glomerular filtration rate (GFR) were determined in all patients. In all studied pts together, three multiple-regression analyses were performed with one set cystatin C as a dependent variable, in the second GFR according to the Cockcroft-Gault formula and in the third creatinine clearance by Modification of Diet in Renal Disease (MDRD) formula. As independent variables, aPL of either type were inserted in addition to disease duration and age. IgG aCL was significantly positively associated with serum cystatin C (p = 0.002), significantly negatively associated with creatinine clearance according to the Cockcroft-Gault and MDRD formula (p = 0.01 and 0.02, respectively). IgG a-B2GPI was significantly negatively associated with creatinine clearance according to the Cockcroft-Gault (p = 0.03) and MDRD (p = 0.01) formula. IgM aCL and IgM a-B2GPI were not associated with any markers of the renal function. Our study suggests the relationship between kidney involvement and the positivity for some aPL in patients with SSc. Positivity for IgG aCL and IgG a-B2GPI in patients with SSc without secondary antiphospholipid syndrome seems to be connected with decrease of glomerular filtration.

Esophageal transit scintigraphy in systemic sclerosis

“…Microangiopathy causes tissue hypoperfusion and ischemia, which lead to atrophy of the neural fibers and autonomic dysfunction. Muscarinic-3 acetylcholine receptor autoantibodies, detected in the majority of patients with GI involvement, may directly disrupt cholinergic neurotransmission in the smooth muscles [4]. As a consequence, esophageal reflexes are weakened or suppressed, greatly impairing peristalsis.…”

Current Views on the Heterogeneity of Renal Involvements in Patients With Systemic Sclerosis

“…Наибольший интерес представляет иссле-дование E. Wielosz и соавт. [76], в котором предпринята по-пытка выявить связь между наличием аФЛ у пациентов с ССД и почечной функцией. Все пациенты, страдающие ССД, как лимитированной, так и диффузной формой, бы-ли распределены в две группы в зависимости от выявления у них аФЛ в любых, даже слабо позитивных, титрах.…”

Gastroesophageal Reflux Disease-Related Disorders of Systemic Sclerosis Based on the Analysis of 66 Patients

“…For symptomatic disorders of the esophagus, it was reported that 74% of SSc patients had some GERD symptoms [14], but only 50% of SSc patients with RE had typical GERD symptoms [15]. Some previous studies denoted that neither disease duration nor the type of SSc has any significant association with GERD symptoms [16,17].…”