title: Prolactin, estradiol and anticardiolipin antibodies in premenopausal women with systemic lupus erythematosus: a pilot study.
abstract: BACKGROUND
  Systemic lupus erythematosus (SLE) is an autoimmune disease, with higher prevalence in women. An incidence peak occurs during the reproductive years, suggesting that estradiol may play a role in the clinical presentation of SLE. Anticardiolipin antibodies (ACA) are associated with antiphospholipid antibody syndrome (APLS), but can be found in patients with SLE without APLS, and relate to cardiovascular risk and nephrite.
  
  
  OBJECTIVE
  This study aimed at assessing whether the presence of ACA is associated with hormonal changes in a sample of women with SLE.
  
  
  METHODS
  Forty-seven women diagnosed with SLE according to the American College of Rheumatology criteria, aged 30.8 ± 8.12 years, were evaluated. None was on hormonal contraception, and their SLE activity was estimated using the SLE Disease Activity Index (SLEDAI). Patients were stratified, according to the presence or absence of ACA, and estradiol and prolactin levels were measured.
  
  
  RESULTS
  Nine (19.1%) of 47 patients were positive for ACA. No differences were found between groups concerning age, duration of disease, and SLEDAI. In contrast, the median estradiol level was lower in the ACA-positive group [46.8 (21.0-72.1) pg/mL] than in the ACA-negative group [122.3 (64.8-172.7) pg/mL, P = 0.004].
  
  
  CONCLUSIONS
  These results suggest, for the first time, an inverse association between ACA and estradiol levels in premenopausal SLE patients. Considering that both lower endogenous estradiol levels and ACA positivity are related to atherosclerosis, our finding may be clinically relevant in predicting cardiovascular risk and/or APLS development in SLE.
authors.affiliation: Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brasil.
authors.forename: Fabiane
authors.initials: F
authors.lastname: Tiskievicz
authors.forename: Elaine S
authors.initials: ES
authors.lastname: Mallmann
authors.forename: João C T
authors.initials: JC
authors.lastname: Brenol
authors.forename: Ricardo M
authors.initials: RM
authors.lastname: Xavier
authors.forename: Poli Mara
authors.initials: PM
authors.lastname: Spritzer
mesh_terms: D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood*; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood*; D010865:Pilot Projects; D017697:Premenopause; D011388:Prolactin / Q000097:blood*
chemical_list: D017153:Antibodies, Anticardiolipin; D004958:Estradiol; D011388:Prolactin