[Is the primary antiphospholipid syndrome a forerunner of SLE?].
BACKGROUND
Antiphospholipid syndrome is a multi-organ autoimmune disorder, characterized by arterial and venous thrombotic events, and a well-defined group of recurrent foetal wasteage due to pathologic antibodies against phospholipids and protein co-factors. Antiphospholipid antibodies can be formed in primary antiphospholipid syndrome, but also in other conditions, most often in systemic lupus erythematosus. This may modify the outcome of lupus increasing the risk for thrombotic complications. Less is known about the outcome in primary antiphospholipid syndrome, whether it may precede the development of systemic lupus.


OBJECTIVE
Authors hereby describe the case of four patients with primary antiphospholipid syndrome in whom the disease progressed to systemic lupus erythematosus.


RESULTS
Lupus followed the primary antiphospholipid syndrome within around a three-year period. It was indicated by the appearance of different antinuclear autoantibodies and clinical complications, such as polyarthritis, nephritis and hematologic disturbances. All of the patients presented cerebrovascular accident as the thrombotic manifestation. All but one, were around forty years old, and had a milder form of lupus. Symptoms of the antiphospholipid syndrome determined the outcome. On the other hand, a typical lupus developed in the youngest patient.


CONCLUSIONS
According to present cases antiphospholipid syndrome may be considered as the initiative phase of SLE, but APS being a separate entity also may associate to lupus. Present observations indicate the importance of follow-up the patients with APS by immunologic respect. Future prospective, multi-centre studies with larger number of cases are needed to provide further evidence on the fact that patients with APS may acquire other autoimmune disorder.
Tarr
Tünde
T
Debreceni Egyetem Orvos- és Egészségtudományi Centrum, Altalános Orvostudományi Kar, Belgyógyászati Intézet, III. Belgyógyászati Klinika, Klinikai Immunológiai Tanszék.
Muzes
Györgyi
G
Pitlik
Ervin
E
Lakos
Gabriella
G
Csépány
Tünde
T
Soltész
Pál
P
Zeher
Margit
M
Szegedi
Gyula
G
Kiss
Emese
E
D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D008875:Middle Aged
D017152:Antibodies, Antiphospholipid