Do all antiphospholipid antibodies confer the same risk for major organ involvement in systemic lupus erythematosus patients?
Por:
Riancho-Zarrabeitia, L, Martinez-Taboada, V, Rua-Figueroa, I, Alonso, F, Galindo-Izquierdo, M, Ovalles, J, Olive-Marques, A, Vazquez, NM, Calvo-Alen, J, Menor-Almagro, R, Tomero-Muriel, E, Uriarte-Isacelaya, E, Botenau, A, Andres, M, Freire-Gonzalez, M, Soler, GS, Ruiz-Lucea, E, Ibanez-Barcelo, M, Castellvi, I, Galisteo, C, Vila, VQ, Raya, E, Narvaez, J, Exposito, L, Hernandez-Beriain, JA, Horcada, L, Aurrecoechea, E, Pego-Reigosa, JM
Publicada:
1 may 2021
Resumen:
Objective
We aimed to investigate the association between the different antiphospholipid antibodies (aPL) and both systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) manifestations.
Methods
Patients from the RELESSER registry, a Spanish retrospective, cross-sectional, forty-five hospital registry of adult SLE patients, were included.
Results
Out of a total of 3,658 SLE patients, 1372 were aPL positive (555 of them fulfilled criteria for APS). All aPL types showed a negative association with cutaneous SLE manifestations. Lupus anticoagulant (LA) and anticardiolipin antibodies (aCL) were both associated with haematological, ophthalmological and neuropsychiatric manifestations. IgG isotypes were associated with a higher risk of lupus manifestations compared with IgM. We found that the risk of neuropsychiatric and ophthalmological manifestations significantly increased with a higher number of positive aPL whereas the risk of cutaneous symptoms showed a negative correlation. All types of aPL, and more strongly LA, were associated with non-criteria antiphospholipid syndrome (APS) manifestations such as thrombocytopenia and haemolytic anaemia. Moreover, LA and aCL (particularly IgG isotype) were also associated with Libman-Sacks endocarditis and cognitive impairment. This association was stronger with more than one positive aPL. All types of aPL were also associated with classic APS manifestations, although LA, IgG isotypes, and patients with more than one aPL displayed a higher risk.
Conclusion
There is a hierarchy for aPL and the risk of APS and SLE manifestations. aCL, and especially LA, confer a higher risk for major organ involvement in SLE. IgG isotypes seem to have a more important role. The load of aPL confer a higher risk for APS and certain SLE manifestations.
Filiaciones:
Riancho-Zarrabeitia, L:
Hosp Sierrallana, IDIVAL, Dept Rheumatol, Torrelavega, Spain
Martinez-Taboada, V:
Hosp Sierrallana, IDIVAL, Dept Rheumatol, Torrelavega, Spain
Univ Cantabria, Hosp Univ Doctor Negrin, IDIVAL, Cantabria, Spain
Rua-Figueroa, I:
Hosp Univ Doctor Negrin, Los Palmas, Spain
Alonso, F:
Soc Espanola Reumatol, Unidad Invest, Madrid, Spain
Galindo-Izquierdo, M:
Hosp Univ Doce Octubre, Madrid, Spain
Ovalles, J:
Hosp Gen Univ Gregorio Maranon, Barcelona, Spain
Olive-Marques, A:
Hosp Badalona Germans Trias & Pujol, Barcelona, Spain
Vazquez, NM:
Hosp Reg Univ Malaga, Malaga, Spain
Calvo-Alen, J:
Hosp Univ Araba, Alava, Spain
Menor-Almagro, R:
Hosp Jerez, Cadiz, Spain
Tomero-Muriel, E:
Hosp Univ Princesa, Madrid, Spain
Uriarte-Isacelaya, E:
Hosp Univ Donostia, San Sebastian, Spain
Botenau, A:
Hosp Univ Ramon & Cajal, Madrid, Spain
Andres, M:
Hosp Gen Univ Alicante, Alicante, Spain
Freire-Gonzalez, M:
Hosp Univ Juan Canalejo, La Coruna, Spain
Soler, GS:
Hosp Marina Baixa, Alicante, Spain
Ruiz-Lucea, E:
Hosp Univ Basurto, Bilbao, Spain
Ibanez-Barcelo, M:
Hosp Univ Son Llatzer, Palma De Mallorca, Spain
Castellvi, I:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Galisteo, C:
Hosp Univ Parc Tauli, Barcelona, Spain
Vila, VQ:
Hosp Comarcal Monforte, Lugo, Spain
Raya, E:
Hosp Univ Clin San Cecilio, Granada, Spain
Narvaez, J:
Hosp Univ Bellvitge, Barcelona, Spain
Exposito, L:
Hosp Univ Canarias, Tenerife, Spain
Hernandez-Beriain, JA:
Hosp Insular Univ Gran Canaria, Las Palmas Gran Canaria, Spain
Horcada, L:
Complejo Hosp Univ Navarra, Navarra, Spain
Aurrecoechea, E:
Hosp Sierrallana, IDIVAL, Dept Rheumatol, Torrelavega, Spain
Pego-Reigosa, JM:
Univ Vigo IRIDIS Grp, Inst Invest Sanitaria Galicia IISGS, Complejo Hosp, Vigo, Spain
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