The impact of antibody profile in thrombosis associated with primary antiphospholipid syndrome.

Autor: da Silva Saraiva S; Thrombosis and Haemostasis Unit, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480. Cidade Universitária 'ZeferinoVaz' CEP: 13083-970, Campinas, SP, Brazil., de Moraes Mazetto B; Thrombosis and Haemostasis Unit, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480. Cidade Universitária 'ZeferinoVaz' CEP: 13083-970, Campinas, SP, Brazil., Quinteiro Tobaldine L; Thrombosis and Haemostasis Unit, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480. Cidade Universitária 'ZeferinoVaz' CEP: 13083-970, Campinas, SP, Brazil., Pereira Colella M; Thrombosis and Haemostasis Unit, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480. Cidade Universitária 'ZeferinoVaz' CEP: 13083-970, Campinas, SP, Brazil., Vinícius De Paula E; Thrombosis and Haemostasis Unit, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480. Cidade Universitária 'ZeferinoVaz' CEP: 13083-970, Campinas, SP, Brazil.; Discipline of Hematology and Hemotherapy, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil RuaTessália Vieira de Camargo, 126. Cidade Universitária 'Zeferino Vaz' CEP: 13083-887, Campinas, SP, Brazil., Annichinno-Bizzachi J; Thrombosis and Haemostasis Unit, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480. Cidade Universitária 'ZeferinoVaz' CEP: 13083-970, Campinas, SP, Brazil.; Discipline of Hematology and Hemotherapy, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil RuaTessália Vieira de Camargo, 126. Cidade Universitária 'Zeferino Vaz' CEP: 13083-887, Campinas, SP, Brazil., Andrade Orsi F; Thrombosis and Haemostasis Unit, Hematology and Hemotherapy Center, University of Campinas, Rua Carlos Chagas, 480. Cidade Universitária 'ZeferinoVaz' CEP: 13083-970, Campinas, SP, Brazil.; Department of Clinical Pathology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil RuaTessália Vieira de Camargo, 126. CidadeUniversitária 'ZeferinoVaz' CEP: 13083-887, Campinas, SP, Brazil.
Jazyk: angličtina
Zdroj: American journal of hematology [Am J Hematol] 2017 Nov; Vol. 92 (11), pp. 1163-1169. Date of Electronic Publication: 2017 Aug 17.
DOI: 10.1002/ajh.24875
Abstrakt: Triple positivity (TP) for antiphospholipid antibodies(aPL) may identify aPL carriers with poorer prognosis. The clinical impact of TP in primary antiphospholipid syndrome(PAPS) remains unclear and further clinical evidences are needed to validate TP as a marker of severity. The aim of this study was to evaluate the impact of TP on the clinical course of PAPS with thrombosis(t-PAPS). We performed a retrospective analysis of a cohort of t-PAPS patients, comparing groups of patients with TP and non-TP profiles according to their demographic, clinical and laboratory features. We included 105 patients with t-PAPS, the median follow-up time of 3.7 years. Twenty-two patients(21%) had TP; the demographic distribution, the presence of cardiovascular risk factors and the site of thrombosis were similar between TP and non-TP patients. The frequency of thrombotic events did not differ between TP and non-TP patients during the study period. Pregnancy morbidities were more frequent in women with t-PAPS and TP than in those with non-TP profile (80% vs. 52.8%, P = 0.05). Patients with t-PAPS and TP presented, at diagnosis, higher dRVVT ratio (median R = 2.44 vs. 1.57, P < 0.0001), higher aCL titer (median = 50UI vs. 35 UI, P < 0.0001), lower C3 levels (median = 1.08 vs. 1.30 mg dL -1 , P = 0.001), lower C4 levels (median = 0.22 vs. 0.25 mg dL -1 , P = 0.05) and higher frequency of positive ANA test (50% vs. 20%, P = 0.008) than patients with t-PAPS and non-TP. Lower-than-normal levels of C3 was independently associated with TP (OR = 5.1, P = 0.02). The presence of TP in patients with t-PAPS was associated with immune derangement, with no effect on the clinical course of the disease.
(© 2017 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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