title: Antibodies to thromboplastin in systemic lupus erythematosus: isotype distribution and clinical significance in a series of 92 patients.
abstract: We determined the prevalence and relationship with clinical manifestations of antibodies to thromboplastin (aTP) in 92 patients with systemic lupus erythematosus (SLE). Thirty-two (35%) patients had aTP: 13 (14%) were positive for IgG aTP, 13 (14%) for IgM aTP, and 6 (7%) for both. Patients with aTP had an increased incidence of thrombosis (p = 0.01), thrombocytopenia (p < 0.001), hemolytic anemia (p < 0.001), and fetal losses (p = 0.03). When the IgG and IgM aTP isotypes were analysed separately, the IgG aTP were found to be associated with thrombosis (p < 0.001), thrombocytopenia (p < 0.001), and fetal losses (p = 0.02). The IgM aTP were associated with hemolytic anemia (p < 0.001). A correlation was found between the titers of aTP and those of anticardiolipin antibodies, in both IgG (p < 0.01, r = 0.6) and IgM (p < 0.01, r = 0.64) isotypes, and between the titers of IgG aTP and the diluted Russell's viper venom time used to detect the lupus anticoagulant (p < 0.001, r = 0.42). This test is a reliable, reproducible and sensitive assay for the detection of antiphospholipid antibodies, specially in those patients under anticoagulant therapy.
authors.affiliation: Systemic Autoimmune Diseases Unit, Hospital Clínic, Barcelona, Catalonia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Font
authors.forename: A
authors.initials: A
authors.lastname: López-Soto
authors.forename: R
authors.initials: R
authors.lastname: Cervera
authors.forename: F J
authors.initials: FJ
authors.lastname: Casals
authors.forename: J C
authors.initials: JC
authors.lastname: Reverter
authors.forename: F J
authors.initials: FJ
authors.lastname: Muñoz
authors.forename: C
authors.initials: C
authors.lastname: Miret
authors.forename: A
authors.initials: A
authors.lastname: Bové
authors.forename: A
authors.initials: A
authors.lastname: Ordinas
authors.forename: M
authors.initials: M
authors.lastname: Ingelmo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications; D017153:Antibodies, Anticardiolipin / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000150:complications; D001323:Autoantibodies / Q000097:blood*; D016022:Case-Control Studies; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay / Q000706:statistics & numerical data; D005260:Female; D005313:Fetal Death / Q000150:complications; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007132:Immunoglobulin Isotypes / Q000097:blood*; D007075:Immunoglobulin M / Q000097:blood; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013921:Thrombocytopenia / Q000150:complications; D013925:Thromboplastin / Q000276:immunology*; D013927:Thrombosis / Q000150:complications
chemical_list: D017153:Antibodies, Anticardiolipin; D001323:Autoantibodies; D007074:Immunoglobulin G; D007132:Immunoglobulin Isotypes; D007075:Immunoglobulin M; D016682:Lupus Coagulation Inhibitor; D013925:Thromboplastin