Association of IgA Anti-beta2 glycoprotein I with clinical and laboratory manifestations of systemic lupus erythematosus.
OBJECTIVE
IgA isotypes of anticardiolipin and anti-ß(2) glycoprotein I (anti-ß(2)-GPI) are omitted from the revised antiphospholipid syndrome (APS) classification criteria. Multiple studies have found a high prevalence of IgA anti-ß(2)-GPI in systemic lupus erythematosus (SLE). We determined the frequency and associations of IgA anti-ß(2)-GPI in a cohort of patients with SLE.


METHODS
anti-ß(2)-GPI was measured in 796 patients with SLE (93% women, 53% white, 38% African American, mean age 45 yrs). IgA anti-ß(2)-GPI (> 20 phospholipid units) was found in 20%. Using a cohort database, associations with cumulative thrombotic and other manifestations were determined.


RESULTS
of patients with SLE who demonstrated IgA anti-ß(2)-GPI positivity, about 6% had transient ischemic attack (p = 0.070), 4% had superficial thrombophlebitis (p = 0.647), 20% had deep venous thrombosis (p = 0.003), 4% had other venous thrombosis (p = 0.827), 12% had stroke (p = 0.050), and 1% had myocardial infarction (p = 0.397).


CONCLUSIONS
IgG anti-ß(2)-GPI has the strongest association with thrombosis in SLE. However, IgA anti-ß(2)-GPI was more strongly associated with deep venous thrombosis and with stroke than was IgM. These results indicate that assessment of IgA anti-ß(2)-GPI is associated with thrombosis in SLE, and that the classification criteria for APS should be revised to include IgA anti-ß(2)-GPI in patients with SLE.
Department of Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 7500, Baltimore, MD 21205, USA. mpetri@jhmi.edu
Taraneh
T
Mehrani
Michelle
M
Petri
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D008180:Lupus Erythematosus, Systemic / Q000276:immunology* / Q000503:physiopathology*; D008875:Middle Aged; D055815:Young Adult; D053482:beta 2-Glycoprotein I / Q000276:immunology*
D001323:Autoantibodies; D007070:Immunoglobulin A; D053482:beta 2-Glycoprotein I