Diagnostic performance of aPS/PT antibodies in neuropsychiatric lupus and cardiovascular complications of systemic lupus erythematosus

Background: Systemic lupus erythematosus (SLE) is associated with a constellation of complications affecting multiple organs, including neuropsychiatric manifestations (NPSLE) and ischaemic events, leading to increased long-term morbidity. Antiphospholipid antibodies (aPL) are a major determinant of...

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Main Authors: Giuseppe A. Ramirez, Valentina Canti, Stefania Del Rosso, Roberta Erra, Lucia Moiola, Marco Magnoni, Enrica P. Bozzolo, Angelo A. Manfredi, Patrizia Rovere-Querini
Format: Article
Language:English
Published: Taylor & Francis Group 2020-01-01
Series:Autoimmunity
Subjects:
Online Access:http://dx.doi.org/10.1080/08916934.2019.1696778
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author Giuseppe A. Ramirez
Valentina Canti
Stefania Del Rosso
Roberta Erra
Lucia Moiola
Marco Magnoni
Enrica P. Bozzolo
Angelo A. Manfredi
Patrizia Rovere-Querini
author_facet Giuseppe A. Ramirez
Valentina Canti
Stefania Del Rosso
Roberta Erra
Lucia Moiola
Marco Magnoni
Enrica P. Bozzolo
Angelo A. Manfredi
Patrizia Rovere-Querini
author_sort Giuseppe A. Ramirez
collection DOAJ
description Background: Systemic lupus erythematosus (SLE) is associated with a constellation of complications affecting multiple organs, including neuropsychiatric manifestations (NPSLE) and ischaemic events, leading to increased long-term morbidity. Antiphospholipid antibodies (aPL) are a major determinant of vascular inflammation and thromboembolic risk. The diagnostic role of anti-phosphatidylserine/prothrombin (aPS/PT) antibodies in this setting is incompletely defined. Aim: To verify whether aPS/PT add to diagnostics and disease stratification in patients with SLE with or without other aPL. Methods: 131 consecutive patients were studied, including 20 patients with SLE and secondary antiphospholipid syndrome (APS). aPS/PT IgG and IgM were assessed through ELISA and patients were stratified based on the presence of other aPL, on their clinical and laboratory features at time of blood sampling and on their clinical history. Synthetic indices of disease activity, chronic damage and cardiovascular risk were calculated at time of venipuncture. Results: Fifty-one (38.9%) patients with SLE had aPS/PT and 15 (11.5%) patients had aPS/PT as the only aPL (aPS/PT-only). aPS/PT-only patients had a significantly higher prevalence of NPSLE than quadruple aPL-negative patients (p = .007). Patients with aPS/PT were more likely to have a history of ischaemia, thrombocytopenia and Libman–Sacks’ endocarditis. The presence of aPS/PT also associated with previous accrual of at least one damage item (p = .043), but had limited predictive values for damage progression in the short term. Conclusion: aPS/PT antibodies provide non-redundant information that could contribute to risk assessment and stratification of patients with SLE.
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spelling doaj.art-591abdfa8f4b4a9288cc87783a17ad922023-09-15T10:01:08ZengTaylor & Francis GroupAutoimmunity0891-69341607-842X2020-01-01531212710.1080/08916934.2019.16967781696778Diagnostic performance of aPS/PT antibodies in neuropsychiatric lupus and cardiovascular complications of systemic lupus erythematosusGiuseppe A. Ramirez0Valentina Canti1Stefania Del Rosso2Roberta Erra3Lucia Moiola4Marco Magnoni5Enrica P. Bozzolo6Angelo A. Manfredi7Patrizia Rovere-Querini8Università Vita-Salute San RaffaeleUniversità Vita-Salute San RaffaeleIRCCS Ospedale San RaffaeleUniversità Vita-Salute San RaffaeleIRCCS Ospedale San RaffaeleIRCCS Ospedale San RaffaeleIRCCS Ospedale San RaffaeleUniversità Vita-Salute San RaffaeleUniversità Vita-Salute San RaffaeleBackground: Systemic lupus erythematosus (SLE) is associated with a constellation of complications affecting multiple organs, including neuropsychiatric manifestations (NPSLE) and ischaemic events, leading to increased long-term morbidity. Antiphospholipid antibodies (aPL) are a major determinant of vascular inflammation and thromboembolic risk. The diagnostic role of anti-phosphatidylserine/prothrombin (aPS/PT) antibodies in this setting is incompletely defined. Aim: To verify whether aPS/PT add to diagnostics and disease stratification in patients with SLE with or without other aPL. Methods: 131 consecutive patients were studied, including 20 patients with SLE and secondary antiphospholipid syndrome (APS). aPS/PT IgG and IgM were assessed through ELISA and patients were stratified based on the presence of other aPL, on their clinical and laboratory features at time of blood sampling and on their clinical history. Synthetic indices of disease activity, chronic damage and cardiovascular risk were calculated at time of venipuncture. Results: Fifty-one (38.9%) patients with SLE had aPS/PT and 15 (11.5%) patients had aPS/PT as the only aPL (aPS/PT-only). aPS/PT-only patients had a significantly higher prevalence of NPSLE than quadruple aPL-negative patients (p = .007). Patients with aPS/PT were more likely to have a history of ischaemia, thrombocytopenia and Libman–Sacks’ endocarditis. The presence of aPS/PT also associated with previous accrual of at least one damage item (p = .043), but had limited predictive values for damage progression in the short term. Conclusion: aPS/PT antibodies provide non-redundant information that could contribute to risk assessment and stratification of patients with SLE.http://dx.doi.org/10.1080/08916934.2019.1696778anti-phosphatidylserine/prothrombin antibodieslupusantiphospholipidneuropsychiatriccardiovascular riskischaemiathrombocytopeniathrombosisendocarditispregnancy
spellingShingle Giuseppe A. Ramirez
Valentina Canti
Stefania Del Rosso
Roberta Erra
Lucia Moiola
Marco Magnoni
Enrica P. Bozzolo
Angelo A. Manfredi
Patrizia Rovere-Querini
Diagnostic performance of aPS/PT antibodies in neuropsychiatric lupus and cardiovascular complications of systemic lupus erythematosus
Autoimmunity
anti-phosphatidylserine/prothrombin antibodies
lupus
antiphospholipid
neuropsychiatric
cardiovascular risk
ischaemia
thrombocytopenia
thrombosis
endocarditis
pregnancy
title Diagnostic performance of aPS/PT antibodies in neuropsychiatric lupus and cardiovascular complications of systemic lupus erythematosus
title_full Diagnostic performance of aPS/PT antibodies in neuropsychiatric lupus and cardiovascular complications of systemic lupus erythematosus
title_fullStr Diagnostic performance of aPS/PT antibodies in neuropsychiatric lupus and cardiovascular complications of systemic lupus erythematosus
title_full_unstemmed Diagnostic performance of aPS/PT antibodies in neuropsychiatric lupus and cardiovascular complications of systemic lupus erythematosus
title_short Diagnostic performance of aPS/PT antibodies in neuropsychiatric lupus and cardiovascular complications of systemic lupus erythematosus
title_sort diagnostic performance of aps pt antibodies in neuropsychiatric lupus and cardiovascular complications of systemic lupus erythematosus
topic anti-phosphatidylserine/prothrombin antibodies
lupus
antiphospholipid
neuropsychiatric
cardiovascular risk
ischaemia
thrombocytopenia
thrombosis
endocarditis
pregnancy
url http://dx.doi.org/10.1080/08916934.2019.1696778
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