Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Presence of Anti-Phosphatidylserine/Prothrombin Antibodies with Both IgG and IgM Isotypes May Be Associated with the Occurrence of Catastrophic Antiphospholipid Syndrome in Patients with Antiphospholipid Antibodies.
Miyara1, Makoto, Arnaud1, Laurent, Dufat1, Laurent, Diemert1, Marie-Claude, Ankri1, Annick, Mathian1, Alexis, Haroche1, Julien
Catastrophic antiphospholipid syndrome (cAPS) is a life threatening condition with simultaneous thrombosis in multiple organs that can occur in patients with antiphospholipid antibodies (APL). Predictive biological parameters for cAPS have not been defined yet. Anti-phosphatidylserine/prothrombin antibodies (aPS/PT) of either IgG or IgM isotypes or both have been recently associated with the presence of LA. It has not been determined whether aPS/PT isotypes are correlated to clinical features of antiphospholipid syndrome (APS).
157 sera from patients with cAPS (n=29), 58 sera from patients with APS (n=29) and 31 sera from patients with stable antiphospholipid antibodies (APS, either aCL, ab2GPI or LA; ACL levels between 25 and 75 UGPL) without clinical APS manifestations (noAPS; n=19), primarily collected for aCL, b2gPI and/or LA detection, were tested on individual isotype aPS/PT IgG and aPS/PT IgM ELISA assays (INOVA Diagnostics, San Diego, CA). According to manufacturer instructions, aPS/PT titers were considered positive when >30 U/mL.
In noAPS group, 8 patients had aPS/PT IgM (42%) while other patients did not have aPS/PT of IgG or IgM isotype (n=11, 58%). In patients with APS, 3 patients had aPS/PT IgG (10.3%), 6 had aPS/PT IgM (20.7%) and 3 patients had aPS/PT with both isotypes (10.3%) while 17 had no aPS/PT (58.6%). In cAPS group, 4 patients had no aPS/PT (13.8%), 4 patients had aPS/PT IgG (13.8%), 5 had IgM (17.2%) and 15 aPS/PT with both IgG and IgM (51.7%). Proportion of patients with aPS/PT with both isotype was significantly higher in patients with cAPS than in patients with APS without cAPS and patients with stable APL without clinical APS manifestations (p=0.0014 and p<0.0001 respectively using Fisher's exact test). No difference was observed in the proportion of isolated aPS/PT IgG or IgM between cAPS and APS patients or patients with patients with stable APL without clinical APS manifestations. The 3 patients with APS with aPS/PT with both isotypes developed adrenal insufficiency, cerebral venous thrombosis and Budd-Chiari syndrome.
Our data indicate that presence of aPS/PT of both IgG and IgM isotypes may be associated with severe features of APS, especially cAPS.
To cite this abstract, please use the following information:
Miyara, Makoto, Arnaud, Laurent, Dufat, Laurent, Diemert, Marie-Claude, Ankri, Annick, Mathian, Alexis, et al; Presence of Anti-Phosphatidylserine/Prothrombin Antibodies with Both IgG and IgM Isotypes May Be Associated with the Occurrence of Catastrophic Antiphospholipid Syndrome in Patients with Antiphospholipid Antibodies. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :20