title: [Antiphospholipid antibodies evolving into connective tissue disease: follow-up study of women with recurrent misscarriage].
abstract: OBJECTIVE
  The aim of this study was to evaluate the clinical and immunologic profile, the rate of progression to connective tissue disease and the possible predictors of evolution in patients with antiphospholipid antibodies and abortions.
  
  
  METHODS
  In a prospective follow-up study, we determined the prevalence of antiphospholipid antibodies as well as other autoimmune abnormalities and the evolution to connective tissue disease in 200 women with unexplained recurrent abortions. IgG and IgM anticardiolipin antibodies were determined by ELISA and the lupus anticoagulant was determined by means of coagulometric tests.
  
  
  RESULTS
  Of 200 women with pregnancy losses, 69 (34.5%) had antiphospholipid antibodies. Thirty-one of 200 women (15.5%) had high or moderate positive anticardiolipin antibodies. During a mean follow-up of 32 months, 9 (13%) antiphospholipid-antibody-positive patients developed features of lupus- like disease or systemic lupus erythematosus. A low total hemolytic complement, increased circulating immune complexes and positive antinuclear antibodies (ANA) were more common in those patients evolving to a connective tissue disorder (p < 0.001, p = 0.003 and p < 0.001, respectively). Positive ANA in women with antiphospholipid antibodies predicted independently the evolution to a connective tissue disorder [Cox proportional hazard model; relative hazard = 4.92, p = 0.04].
  
  
  CONCLUSIONS
  A subgroup of patients with antiphospholipid antibodies and abortions may progress to a connective tissue disorder. A positive antinuclear antibody test result could be useful to identify those patients with antiphospholipid antibodies and abortions who are prone to evolve into a systemic autoimmune disease.
authors.affiliation: Unidad de Inmunología Clínica. Servicio de Inmunología. Hospital General Universitario Gregorio Marañón. Madrid. España. carbone@teleline.es
authors.forename: Javier
authors.initials: J
authors.lastname: Carbone
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sarmiento
authors.forename: Paloma
authors.initials: P
authors.lastname: Segovia
authors.forename: Margarita
authors.initials: M
authors.lastname: Rodríguez-Mahou
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Rodríguez-Molina
authors.forename: Eduardo
authors.initials: E
authors.lastname: Fernández-Cruz
mesh_terms: D000026:Abortion, Habitual / Q000276:immunology*; D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000276:immunology*; D003240:Connective Tissue Diseases / Q000276:immunology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D017152:Antibodies, Antiphospholipid