Session Title: Antiphospholipid Syndrome
Session Type: Abstract Submissions (ACR)
The aims of our prospective study were to determine the prevalence of non-criteria aPL and their clinical relevance in a seronegative population with pregnancy morbidity according to Sapporo criteria.
We included 118 women: 73 with history of pregnancy morbidity according to clinical Sapporo’s criteria (SN-APS), 38 patients with confirmed obstetrical APS (SP-APS) and 45 with pregnancy without any obstetrical complication (Controls). Other than APS thrombophilia screening was negative in all women (protein C, S, ATIII, V and II mutations).
The IgG/ IgM anti-phosphatidylethanolamine antibodies (aPE), IgG/IgM anti-phosphatidylserin/prothrombin antibodies (aPS/PT) and IgG anti-annexin 5 antibodies (aANX) were measured by commercial ELISAs (Theradiag, Instrumentation laboratory).
Among the SN-APS group, 47% women presented ≥ 3 early miscarriages, 43% mid-to-late pregnancy loss and 22% premature birth <34 weeks of gestation related to placental insufficiency.
Non-criteria aPL were detected in 32% of SN-APS and 72% SP-APS and 13% controls (p<0.05). Among the non-criteria aPL antibodies, only the aPE IgG were more frequent in SN-APS patients than controls (18% vs 2%; p<0.05) and the levels of IgG aPE and IgG aANX were higher in SN-APS patients (median titres 6 U/mL and 8 U/mL, respectively), than in controls (2 U/mL and 2 U/mL, respectively; p<0.0001)(figures 2-3). Non-criteria aPL antibodies were present in 74% SP-APS versus 33% of SN-APS (p<0.05). APS/PT antibodies were more frequent in the SP-APS group: 48% vs 4.4% in controls and 2.2% in SN-APS (p<0.001). IgA anti-β2GPI antibodies were negative in SN-APS vs 23% SP-APS. Antibodies to anti-domain I of β2GPI were absent in SN-APS vs 30% of SP-APS. None of the five aPL antibodies was associated with specific obstetrical feature in SN-APS.
Our results suggest that non-criteria antibodies can be detected in 33% of women with obstetrical complications suggestive of APS with negative aPL.
Figure 1. The prevalence of non-criteria APL in SN-APS, SP-APS and controls.
Figure 3. Anti-PE IgG titres in different groups.
Figure 2. The frequency of different non-criteria APS prevalence in SN-APS, SP-APS and controls.
M. C. Bourrienne,
S. chollet Martin,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/non-criteria-antiphospholipid-antibodies-in-obstetrical-seronegative-anti-phospholipid-syndrome/