[Role of anti-prothrombin in antiphospholipid syndrome].
We studied 99 patients with systemic autoimmune disease (5 males, 94 women; mean age 37 year, range 16-72): 28 Primary Antiphospholipid Syndrome, 67 Systemic lupus Erythematosus, 1 Mixed Connective Tissue Disease, 2 Undifferentiated Connective Tissue Disease and 1 Discoid Lupus. Based on the observation that native PT shows conformational changes in presence of Ca++ ions and discloses new epitopes available for binding with phospholipids, we performed 3 different methods for the detection of aPT in presence and absence of Ca++, finding a different incidence of specific autoantibodies, associated with clinical features of APS (aPT in presence of Ca++) or non associated (aPT in absence of Ca++). The presence of aPT was significantly associated also with the presence of Lupus Anticoagulant (LAC). The detection of aPT (in presence of Ca++) significantly enhances diagnostic sensibility of APS allowing the identification of a subset of patients (6/99) with clinical features of APS, but with negative LAC, aCL and a beta2-GPI; in fact (limited to thrombotic episodes) the sensibility rises from 56.2% with one test (LAC) to 81.1% with the application of LAC, aCL, a(beta)2GPI and aPT.
Cinquini
M
M
Servizio di Reumatologia, Allergologia ed Immunologia Clinica, Spedali Civili di Brescia, Cattedra di Allergologia ed Immunologia Clinica dell' Università degli Studi di Brescia.
Vianelli
M
M
Allegri
F
F
Cattaneo
R
R
Balestrieri
G
G
Tincani
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000918:Antibody Specificity; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D002118:Calcium / Q000494:pharmacology; D002614:Chelating Agents / Q000494:pharmacology; D003240:Connective Tissue Diseases / Q000150:complications / Q000276:immunology; D004492:Edetic Acid / Q000494:pharmacology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006023:Glycoproteins / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D016682:Lupus Coagulation Inhibitor / Q000032:analysis; D008179:Lupus Erythematosus, Discoid / Q000150:complications / Q000276:immunology; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000276:immunology; D008297:Male; D008875:Middle Aged; D008947:Mixed Connective Tissue Disease / Q000150:complications / Q000276:immunology; D011237:Predictive Value of Tests; D011516:Prothrombin / Q000276:immunology*; D011517:Prothrombin Time; D019851:Thrombophilia / Q000209:etiology / Q000276:immunology*; D053482:beta 2-Glycoprotein I
D001323:Autoantibodies; D002614:Chelating Agents; D006023:Glycoproteins; D007074:Immunoglobulin G; D016682:Lupus Coagulation Inhibitor; D053482:beta 2-Glycoprotein I; D011516:Prothrombin; D004492:Edetic Acid; D002118:Calcium