Jornal de Imunologia Clínica e Celular
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Clinical Features and Pattern of Antiphospholipid Antibodies in Patients of Antiphospholipid Syndrome (APS) with Systemic Lupus Erythematosus (SLE)

Sheharbano Imran, Qasim Ahmed

Background: Evaluation of antiphospholipid antibodies (aPL) profile in Systemic lupus erythematosus (SLE) patients with obstetric and thrombotic complications and to see the association of different anti phospholipid antibodies in different clinical features of Antiphospholipid syndrome (APS) in SLE patients.

Materials and methods: Cross sectional prospective interdisciplinary study was conducted between July 2019 to January 2021 at the Section of Chemical Pathology and Department of Rheumatology, Fatima Memorial Hospital Lahore.

After taking IRB approval, diagnosed cases of APS with SLE presenting with thrombosis and pregnancy complication were studied. After informed consent, performa was filled by patient including age, gender and clinical symptoms. Blood sample were taken for Anti-beta-2-glycoprotein 1(anti-b2GPI), anticardiolipin (aCL) analyze on Alegria based on ELISA.

Results: Total of 60 diagnosed patients of SLE, presenting with thrombosis or pregnancy complications were included in the study. Mean age of patients was 31.3 ± 5.3 years. There were 56 (93.3%) female and 4 (6.7%) male patients.

Non-thrombotic lupus manifestations in decreasing orders were; cutaneous features in 40 (66.7%), oral ulcers in 33 (58.3%), arthritis and nephritis each in 23 (38.3%), neuropsychiatric manifestation in 7 (11.6%), and serositis in 4 (6.7%) patients.

Among thrombotic manifestations; pregnancy loss was reported in 30 (50%) with 22 (36%) in first trimester and 8 (14%) in 2nd trimester, deep venous thrombosis of extremities was noted in 14 (23.3%), thromboembolic stroke in 11 (18.3%), arterial thrombosis in 5 (8.3%), and pre-eclampsia was reported in 4 (7.1%) patients.

Out of 60 patients with SLE, 18 (30%) were positive with single APLS antibody, 28 (46.7%) were positive with double –antibodies and 14 (23.3%) were positive with triple positive APLS. Person who had five thrombotic events was triple ELISA positive as compared to person who had 1 or two thrombotic events were double ELISA positive.

Conclusion: aPLS antibodies of any type and number leads to cumulative obstetric and thrombotic complication in SLE, which is higher in high risk antibody profiles.