ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 19

Association Of Antiphospholipid Antibodied Detected In The Aphl ELISA With Clinical Manifestations Of The Antiphospholipid Syndrome In Two Lupus Cohorts

Silvia S. Pierangeli1, Rohan Willis2, Michelle Petri3, Hong Fang4, Monica Smikle5, Karel de Ceulaer6 and E. Nigel Harris7, 1Rheumatology/Dept Int Med, University of Texas Medical Branch, Galveston, TX, 2Int Medicine/Rheumatology, University of Texas Medical Branch, Galveston, TX, 3Johns Hopkins University School of Medicine, Baltimore, MD, 4Div of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, 5Microbiology, University of the West Indies, Kgn 7, Jamaica, 6Microbiology, University of the West Indies, KIngston, Jamaica, 7Office of the Vice Chancellor, The University of the West Ind, Kingston, Jamaica

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: , ,

Session Information

Title: Antiphospholipid Syndrome: Clinical Manifestations and New Biomarkers in Antiphospholipid Syndrome

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Antiphospholipid Syndrome (APS) is characterized by the presence of antibodies to phospholipid (aPL) and to β2glycoprotein I (β2GPI) in patients with thrombosis or pregnancy morbidity.  Anticardiolipin (aCL) assays are used to confirm the diagnosis of APS. Although a sensitive assay, aCL is often found positive in a number of infectious, drug-induced and non APS related autoimmune diseases.   The APhL ELISA is an immunoassay that detects antibodies to negatively charged phospholipids in the presence of β2GPI and has been shown to be more specific and as sensitive as the aCL in the diagnosis of APS. Here we examined the association aPL antibodies detected in the APhL ELISA with clinical manifestations of APS in two lupus cohorts.

Methods:

A total of 590 serum samples from patients with lupus (diagnosed according to ACR criteria) from the HOPKINS cohort (n=543) and from the University of the West Indies Rheumatology Department Jamaica cohort (n=47) were analyzed for IgG and IgM aPL antibodies using the APhL ELISA (Louisville APL Diagnostics), following the manufacturer’s instructions.  Samples were considered positive when above 15 GPL or MPL units for IgG and IgM, respectively.   Association of venous thrombois, arterial thrombosis, any thrombosis, diagnosis of APS (Sapporo revised criteria), any miscarriage, any pregnancy morbidity or toxemia with a positive APhL test (either IgG or IgM) was assessed by univariate analysis, using the SPSS® v20.0 software.

Results:

IgG APhL

P

OR

95% CI

Venous thrombosis

0.000

3.5

1.9-6.3

Arterial thrombosis

0.070

1.8

1.0-3.5

Any thrombosis

0.000

3.1

1.7-5.8

Diagnosis of APS

0.000

5.8

2.7-12.1

Any miscarriage

0.022

2.2

1.1-4.1

Any pregnancy morbidity

0.007

2.5

1.3-4.7

Toxemia

0.007

3.1

1.4-6.8

Any APhL positive test was significantly associated with venous, arterial, any thrombosis and with diagnosis of APS, but no association of IgM APhL positivity with clinical manifestations was observed. There was no difference in the results when data were calculated combined or individually in each cohort.

Conclusion:

The APhL ELISA is an excellent test to detect aPL associated with thrombosis and pregnancy morbidity in patients with lupus.

Disclosure:

S. S. Pierangeli,

Louisville APL Diagnostics, Inc,

4;

R. Willis,
None;

M. Petri,

Anthera, Gaxo, Medimmune, TEVA, UCB,Pfizer,

2,

Anthera, UCB, Genentech,Glaxo,Medimmune, Pfizer,

5;

H. Fang,
None;

M. Smikle,
None;

K. de Ceulaer,
None;

E. N. Harris,

Louisville APL Diagnostics, Inc,

5.

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