The prevalence of antiphospholipid antibody syndrome among systemic lupus erythematosus patients.
Systemic lupus erythematosus (SLE) is an autoimmune disease characterised by excess autoantibody production. It typically affects women of childbearing age. Antiphospholipid antibody syndrome (APLAs) is associated with serious co-morbidity to mother and child characterized by recurrent vascular thrombosis and/or pregnancy associated morbidity. We reviewed SLE patients attending a specialist connective tissue disease clinic both to assess the occurrence of APLAs and its clinical presentations and to audit the effectiveness of screening for APL antibodies in a specialist clinic. 204 patients attended the newly established connective tissue disease outpatient clinic over a twenty-seven month period; 42 (34 female, 8 male) with a diagnosis of SLE. Ten patients (24%), eight female and 2 male with a median age of 38.5 years (range 20 to 64 years) fulfilled the ACR criteria for secondary APLAs (Table 2). The commonest clinical presentation was pulmonary embolus (five patients). Overall 37 patients (88%) with SLE were screened for APLAs during the study period: 94% of females and 62.5% of males were screened (for anticardiolipin antibodies, lupus anticoagulant or both), 27% had evidence of APLAs, 24% had positive antibodies but were asymptomatic. There is a significant occurrence of APLAs among SLE patients. Given the important clinical implications of this disorder including substantial risk of fetal loss and patient morbidity or mortality, routine screening of all SLE patients for APL antibodies is recommended.
McMahon
M A
MA
Department of Rheumatology and Immunology, Beaumont Hospital, Dublin 9, Ireland.
Keogan
M
M
O'Connell
P
P
Kearns
G
G
D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors