Is the determination of anti-beta2 glycoprotein I antibodies useful in patients with venous thromboembolism without the antiphospholipid syndrome?
Anti-beta2-glycoprotein I (beta2GPI) antibodies are frequently found in patients with lupus anticoagulant (LA). To investigate the prevalence of antibeta2GPI antibodies and their clinical impact in patients with a history of venous thromboembolism (VTE) without LA/anticardiolipin antibodies (ACA), we studied 503 patients [128 (36.2%) men, median age 41 years (interquartile range, IQR 28-54 years)] with previous thrombosis. A group of 113 individuals without VTE [43 (38.1%) men, age 46.7 years (IQR 38-52 years)] served as a control group. Among 418 patients without LA/ACA, anti-beta2GPI-IgG levels were elevated in seven (1.7%), -IgM in 15 (3.6%) and -IgA in 14 (3.3%) cases; in 58 patients with ACA, anti-beta2GPI-IgG levels were elevated in two (3.4%), six (10.3%) and three (5.2%), and in 27 with LA, they were elevated in 18 (66.7%), 19 (70.4%) and 10 (37%) respectively. Thus, the prevalence of elevated anti-beta2GPI antibodies was not increased in patients without LA/ACA but was strongly associated with LA. Patients without ACA/LA who had a recurrent event did not have higher prevalence of elevated anti-beta2GPI-IgG, -IgM or -IgA antibodies than those without a recurrent event. Thus, elevated antibeta2GPI antibodies are not likely to be a predictor of recurrent events in patients without LA. We conclude that determination of anti-beta2GPI antibodies does not improve the clinical management of patients with a history of VTE without LA/ACA.
Hsieh
Kety
K
Department of Internal Medicine I, Division of Haematology and Blood Coagulation, Vienna University Hospital, Wilheminenspital, Vienna, Austria.
Knöbl
Paul
P
Rintelen
Claudia
C
Kyrle
Paul A
PA
Quehenberger
Peter
P
Bialonczyk
Christine
C
Partsch
Hugo
H
Lechner
Klaus
K
Pabinger
Ingrid
I
D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D006023:Glycoproteins / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood*; D007075:Immunoglobulin M / Q000097:blood; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D018709:Statistics, Nonparametric; D013923:Thromboembolism / Q000276:immunology*; D053482:beta 2-Glycoprotein I
D017153:Antibodies, Anticardiolipin; D001323:Autoantibodies; D006023:Glycoproteins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D016682:Lupus Coagulation Inhibitor; D053482:beta 2-Glycoprotein I