title: Autoimmune liver diseases and antiphospholipid antibodies positivity: a meta-analysis of literature studies.
abstract: OBJECTIVE
  Several studies reported an association between autoimmune liver diseases (AiLD) and antiphospholipid antibodies (aPL) positivity. We performed a meta-analysis of studies evaluating the association of primary biliary cirrhosis (PBC), autoimmune hepatitis (AIH), and primary sclerosing cholangitis (PSC) with aPL positivity and with aPL-related thrombotic events.
  
  
  METHODS
  Studies evaluating the association of AiLD with aPL (anticardiolipin [aCL], anti-β2 glycoprotein-I [anti-β2GPI], lupus anticoagulant [LA] antibodies) and with aPL-related thrombotic complications were systematically searched in the PubMed, Web of Science, Scopus and EMBASE databases.
  
  
  RESULTS
  A total of 10 studies (750 patients with AiLD and 1,244 healthy controls) were included in the analysis on the prevalence of aPL and showed that AiLD are significantly associated with the presence of aCL and anti-β2GPI. The association with aCL positivity was consistently confirmed in PBC (OR: 13.93, 95%CI: 4.69-41.38), AIH (OR: 23.50, 95%CI: 4.28-129.13), and PSC (OR: 18.21, 95%CI: 7.05-47.08). Similarly, anti-β2GPI were found more frequently in PBC (OR: 25.10, 95%CI: 4.77-132.11), AIH (OR: 48.57, 95%CI: 11.07-213.09), and PSC (OR: 36.30, 95%CI: 6.55-201.31). These findings are confirmed when separately analyzing IgM, IgG, and IgA directed against phospholipids. Two of the 10 included articles and 1 further study (67 cases and 75 controls) showed a trend - not achieving statistical significance - towards a higher prevalence of thrombotic complications in AIH patients with aPL as compared to those with only AIH (OR: 1.67, 95%CI: 0.46-6.05).
  
  
  CONCLUSIONS
  PBC, AIH, and PSC are significantly associated with aPL positivity. The association with aPL-related thrombotic complications should be further studied.
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Ambrosino
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Lupoli
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: Gaia
authors.initials: G
authors.lastname: Spadarella
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Tarantino
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Di Minno
authors.affiliation: Department of Surgery, Interventional Hepatology Unit, Andrea Tortora Hospital, Pagani, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Tarantino
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples; Unit of Cell and Molecular Biology in Cardiovascular Diseases, Centro Cardiologico Monzino, IRCCS, Milan, Italy. dario.diminno@hotmail.it.
authors.forename: Matteo Nicola Dario
authors.initials: MN
authors.lastname: Di Minno
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000097:blood / Q000276:immunology*; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D015551:Autoimmunity; D016009:Chi-Square Distribution; D015209:Cholangitis, Sclerosing / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D019693:Hepatitis, Autoimmune / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D016017:Odds Ratio; D011379:Prognosis; D012307:Risk Factors; D013927:Thrombosis / Q000276:immunology
chemical_list: D017152:Antibodies, Antiphospholipid