Antiphospholipid Antibodies and Systemic Scleroderma

Abstract

Objective: Antiphospholipid antibodies (APLs) could be associated with an increased risk of vascular pathologies in systemic scleroderma. The aim of our study was to search for APLs in patients affected by systemic scleroderma and to evaluate their involvement in the clinical manifestations of this disease.Materials and Methods: We conducted a cross-sectional descriptive study, from January 2009 until August 2010, with patients received at the Department of Dermatology (Dakar, Senegal). Blood samples were taken at the hematology laboratory and were analyzed for the presence of APLs.Results: Forty patients were recruited. Various types of either isolated or associated APLs were found in 23 patients, i.e. 57.5% of the study population. The most frequently encountered antibody was IgG anti-β2 GPI (37.5% of the patients), followed by anticardiolipins (17.5%) and lupus anticoagulants (5%). No statistically significant association of positive antiphospholipid-related tests to any of the scleroderma complications could be demonstrated.Conclusion: A high proportion of patients showing association of systemic scleroderma and APLs suggests the presence of a morbid correlation between these 2 pathologies. It would be useful to follow a cohort of patients affected by systemic scleroderma in order to monitor vascular complications following confirmation of the presence of antiphospholipid syndrome.Conflict of interest:None declared.

Prevalence and Clinical Associations of Antiphospholipid Antibodies in Systemic Sclerosis: New Data From a French Cross-Sectional Study, Systematic Review, and Meta-Analysis

“…Meta-regression did not find any association between the risk of bias and the prevalence of aPL (Table 6 ). Moreover, the aforementioned analyses were performed in duplicate for the five studies for which both LA, aCL and anti-β2GpI were tested [( 8 , 10 , 22 , 26 ), in this study]. The prevalence of aPL, LA, aCL, and anti-β2GpI were 24% (7–47), 1% (0–4), 11% (4–19), and 10% (1–27), respectively.…”

Influence of antiphospholipid antibody positivity on glomerular filtration rate markers in a group of systemic sclerosis patients – a 24-month observation

“…According to Morrisroe et al ., the presence of aPL antibodies is associated with interstitial lung disease (ILD), pulmonary arterial hypertension (PAH), Raynaud’s phenomenon and digital ulcers [ 19 ] and suggests that endothelial abnormalities and small vessel thrombosis may be important in the pathogenesis of these SSc features [ 19 ]. On the other hand, there are some data, which do not find significant differences in clinical manifestations of SSc between the aPL positive and aPL negative group [ 8 ]. However, in the majority of papers, mean serum levels of aPL were below the cut-off values required for the diagnosis of APS, and the issue whether low titre aPL are pathogenic or not in SSc patients is open to debate [ 6 , 10 , 19 ].…”

“…Moreover, some reports describe, severe vascular complications in SSc patients, such as pulmonary arterial hypertension (PAH), proteinuria, deterioration of kidney function occurring more frequently in aPL positive patients though none of the patients had clinical features of APS [ 10 ]. In the literature available, there are some data about the influence of aPL presence on GFR but no information about long – term influence of aPL antibodies on GFR in patients with SSc [ 5 , 6 , 8 ]. The aim of the study was the assessment of changes in GFR markers during the 24-months observation of a group of SSc patients with and without chronic aPL positivity.…”

Antiphospholipid Syndrome - A Case Report of Pulmonary Thromboembolism, Followed with Acute Myocardial Infarction in Patient with Systemic Sclerosis

“…38.9% of patients with SSc had antiphospholipid antibody presence associated with low complement level, in the absence of any clinical feature of APLs. Toure, in his study of 40 pts with SSc identified APLa in 57.3% of them [ 7 , 8 ].…”