Antiphospholipid syndrome and systemic lupus erythematosus: are they separate entities or just clinical presentations on the same scale?
OBJECTIVE
Although originally described in the context of systemic lupus erythematosus, antiphospholipid syndrome was then recognized as a primary antiphospholipid syndrome without any underlying autoimmune disease in almost half of the cases. However, cases of primary antiphospholipid syndrome were reported to evolve into systemic lupus erythematosus over time suggesting that these apparently different diseases are somehow related.


RESULTS
Peculiar biological systemic lupus erythematosus markers such as an autoantibody response against chromatin antigens and complement activation have been also described in patients with primary antiphospholipid syndrome. Distinct polymorphisms of common genetic factors have been associated with systemic lupus erythematosus and primary antiphospholipid syndrome supporting the notion that these entities are indeed variants within a continuum of the same disease.


CONCLUSIONS
A multiorgan involvement that cannot be explained by the thrombophilic state per se and similar to the well known clinical manifestations in lupus is reported in patients with primary antiphospholipid syndrome. Further studies, mainly genetic, will better underline the proximity between primary antiphospholipid syndrome and systemic lupus erythematosus.
Shoenfeld
Yehuda
Y
Department of Internal Medicine B and Center for Autoimmune Diseases, Sheba Medical Center, Tel-Aviv University, Israel. Shoenfel@post.tau.ac.il
Meroni
Pier Luigi
PL
Toubi
Elias
E
D000974:Antibodies, Antinuclear / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology; D003167:Complement Activation; D003937:Diagnosis, Differential; D020022:Genetic Predisposition to Disease; D006402:Hematologic Diseases / Q000209:etiology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000209:etiology / Q000235:genetics / Q000276:immunology; D008181:Lupus Nephritis / Q000209:etiology; D020945:Lupus Vasculitis, Central Nervous System / Q000209:etiology
D000974:Antibodies, Antinuclear