Thromb Haemost 2006; 96(03): 337-341
DOI: 10.1160/TH06-05-0287
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Antibody profile and clinical course in primary antiphospholipid syndrome with pregnancy morbidity

Amelia Ruffatti
1   Department of Clinical and Experimental Medicine, Division of Rheumatology
,
Marta Tonello
1   Department of Clinical and Experimental Medicine, Division of Rheumatology
,
Teresa Del Ross
1   Department of Clinical and Experimental Medicine, Division of Rheumatology
,
Anna Cavazzana
1   Department of Clinical and Experimental Medicine, Division of Rheumatology
,
Chiara Grava
1   Department of Clinical and Experimental Medicine, Division of Rheumatology
,
Franco Noventa
2   5th Clinical Medicine
,
Francesco Tona
3   Department of Cardio-Thoracic and Vascular Sciences, Clinical Cardiology, University of Padua, Italy
,
Sabino Iliceto
3   Department of Cardio-Thoracic and Vascular Sciences, Clinical Cardiology, University of Padua, Italy
,
Vittorio Pengo
3   Department of Cardio-Thoracic and Vascular Sciences, Clinical Cardiology, University of Padua, Italy
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Received 25. Mai 2006

Accepted after revision 27. Juli 2006

Publikationsdatum:
30. November 2017 (online)

Summary

In women diagnosed as having category I primary obstetric antiphospholipid syndrome, clinical characteristics and the risk of subsequent thromboembolic events and further unsuccessful pregnancy has not been clearly documented. Women with unexplained obstetric complications and no definite autoimmune systemic diseases were tested for lupus anticoagulant (LA), IgG/ IgM anticardiolipin (aCL) and IgG/IgM anti-human β2-Glycoprotein I (aβ2GPI) antibodies and diagnosed as having primary antiphospholipid syndrome (APS) in classification category I on the basis of more than one laboratory criteria present in any combination. Characteristics at the time of diagnosis and risk factors for subsequent clinical events during a mean follow-up of 6.3 years were evaluated. Fifty-three of 600 women studied were found to fulfil obstetric criteria and had more than one positive laboratory test at the time of diagnosis. All the women were a CL and aβ2GPI positive, and 16 were also LA positive. This latter group (triple positivity) had distinct features and had more frequently experienced previous thromboembolism (OR= 122.5, 95% CI 16–957, p<0.001).They also had an increased rate of late pregnancy loss (OR=16.2, 95%CI 0.9–292, p=0.01), and a higher IgG aβ2GPI titer at diagnosis (median, 25th and 75th percentile were 118, 37–962, vs. 23, 18–32, respectively, p<0.0001). During follow-up, the rate of thromboembolic events was significantly higher in the group of women with triple positivity and/ or previous thromboembolism (OR=57.5, 95% CI 2.7–1160, p=0.0004) which were the only independent predictors of TE in the multivariate model. Recurrent pregnancy loss took place in seven out of 47 women who had a new pregnancy. Triple positivity and/or previous thromboembolism were again the only independent markers (OR=34.4, 95% CI 3.5–335.1, p=0.003) of an unsuccessful new pregnancy. In conclusion, in primary APS with pregnancy morbidity in classification category I, quite different groups of patients may be identified on the basis of laboratory tests. Triple positivity and/or a history of thromboembolism predict new TE events and new unsuccessful pregnancies.

 
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