title: Live Birth Pregnancy Outcome after First In Vitro Fertilization Treatment in a Patient with Systemic Lupus Erythematosus and Isolated High Positive IgA Anti-β2glycoprotein I Antibodies: A Case Report.
abstract: IgA anti-β2glycoprotein I antibodies (IgA-anti-β2GPI) seems to be the most prevalent isotype in patients with Systemic Lupus Erythematosus (SLE) with a significant association to thrombotic events. Both SLE and antiphospholipid syndrome (APS) can be associated with implantation failure, fetal loss and obstetric complications. Recent reports highlight the clinical value of IgA-anti-β2GPI determination in supporting in vitro fertilization (IVF) treatment and IVF pregnancy outcomes. We report a 36-year-old female diagnosed with SLE, endometriosis and unexplained infertility. Conventional APS markers were consistently negative: anti-cardiolipin (aCL) and anti-β2GPI: IgG/IgM. She was then tested with reports of repeatedly high IgA-anti-β2GPI and tested positive from 2014 after IgA (aCL; anti-β2GPI) were established in our APS diagnostic panel. She underwent successful first IVF procedure with a 30 week live birth pregnancy outcome. During the follow up no lupus flare, thrombosis or ovarian hyperstimulation syndrome were registered. Serum IgA anti-β2GPI and anti-dsDNA levels declined statistically significant during the second and third trimester. Titres of IgA-anti-β2GPI remained lower postpartum as well. This case highlights the clinical importance of IgA-anti-β2GPI testing for family planning, assisted reproduction and pregnancy in women with SLE and/or APS.
authors.affiliation: Division of Immunology and Transfusion Medicine, Department of Laboratory Medicine, University Hospital of North Norway, Tromsoe, Norway.
authors.forename: Hristina
authors.initials: H
authors.lastname: Andreeva
authors.affiliation: Department of Rheumatology, University Hospital of North Norway, Tromsoe, Norway.
authors.forename: Marit
authors.initials: M
authors.lastname: Seip
authors.affiliation: Division of Immunology and Transfusion Medicine, Department of Laboratory Medicine, University Hospital of North Norway, Tromsoe, Norway.
authors.forename: Stanislava
authors.initials: S
authors.lastname: Koycheva
keywords: Antiphospholipid syndrome; IgA anti-beta2 GPI antibodies; In vitro fertilization; Infertility; Systemic lupus erythematosus; assisted reproductive technology