Objective. Primary antiphospholipid syndrome (APS) is formally classified by the presence of antiphospholipid antibodies, recurrent thrombosis, and/or pregnancy morbidity in the absence of any underlying fullblown systemic autoimmune disease. However, systemic manifestations in patients with primary APS have been recently reported, as has the presence of serologic markers in common with systemic lupus erythematosus (SLE). In spite of similarities between the 2 diseases, only a minority of cases of primary APS evolve into full-blown SLE, even after a long followup period. The aim of this study was to investigate whether the analysis of SLE susceptibility genes may provide at least a partial explanation for such a discrepancy.Methods. One hundred thirty-three patients with primary APS classified according to the Sydney criteria and 468 healthy control subjects from the same geographic area were recruited. We genotyped 3 singlenucleotide polymorphisms (SNPs) in IRF5 (rs2004640, rs2070197, and rs10954213), 4 SNPs in STAT4 (rs1467199, rs3821236, rs3024866, and rs7574865), 2 SNPs in BANK1 (rs10516487 and rs3733197), and 1 SNP in BLK (rs2736340).Results. STAT4 and BLK displayed a strong genetic association with primary APS (for rs7574865, odds ratio [OR] 2.19, P ؍ 5.17 ؋ 10 ؊7 ; for rs2736340, OR 2.06, P ؍ 1.78 ؋ 10 ؊6 ), while a weak association with IRF5 and no association with BANK1 were observed.Conclusion. The presence of a strong genetic association with only a few SLE susceptibility genes and the absence of a more complex gene association may contribute to the lack of cases of full-blown SLE developing in patients with primary APS, in spite of the clinical and serologic similarities between SLE and primary APS.Antiphospholipid syndrome (APS) is characterized by the persistent positivity of antibodies against phospholipid-binding proteins in the presence of recurrent arterial/venous thrombotic events and/or pregnancy morbidity. Although APS was originally described in patients with systemic lupus erythematosus (SLE), more than 50% of cases of APS are now recognized in patients without any underlying full-blown systemic autoimmune disease (e.g., primary APS) (1).Understanding of the clinical spectrum of primary APS has evolved in the past years, with a gradual recognition that it is not merely an autoimmune thrombophilic disorder but, rather, a more systemic disease having several clinical manifestations in common with SLE (1). The similarity of the 2 diseases is further supported by additional biologic findings, i.e., 1) the role of complement activation and, at least for some manifestations, the involvement of inflammatory processes in APS pathogenesis (1), 2) the recent demonstration of the occurrence of antichromatin (i.e., antinucleosome) autoantibodies at medium/high titers in a large propor-