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Type: Journal article
Title: The association of antiphospholipid antibodies with cardiopulmonary manifestations of systemic sclerosis
Author: Morrisroe, K.
Stevens, W.
Nandurkar, H.
Prior, D.
Thakkar, V.
Roddy, J.
Zochling, J.
Sahhar, J.
Tymms, K.
Sturgess, A.
Major, G.
Kermeen, F.
Hill, C.
Walker, J.
Nash, P.
Gabbay, E.
Youssef, P.
Proudman, S.
Nikpour, M.
Citation: Clinical and Experimental Rheumatology, 2014; 32(6 Suppl. 86):S133-S137
Publisher: Pacini editore
Issue Date: 2014
ISSN: 1593-098X
Statement of
K. Morrisroe, W. Stevens, H. Nandurkar, D. Prior, V. Thakkar, J. Roddy, J. Zochling, J. Sahhar, K. Tymms, A. Sturgess, G. Major, F. Kermeen, C. Hill, J. Walker, P. Nash, E. Gabbay, P. Youssef, S. Proudman, M. Nikpour
Abstract: OBJECTIVES: To determine the prevalence and correlates of antiphospholipid antibodies (APLA) in systemic sclerosis (SSc). METHODS: Nine hundred and forty SSc patients were tested for APLA using an ELISA assay at recruitment. Clinical manifestations were defined as present, if ever present from SSc diagnosis. Logistic regression analysis was used to determine the associations of APLA. RESULTS: One or more types of APLA were present in 226 (24.0%) patients. Anticardiolipin (ACA) IgG (ACA-IgG) antibodies were associated with right heart catheter-diagnosed pulmonary arterial hypertension (PAH), with higher titres corresponding with a higher likelihood of PAH (moderate titre (20-39 U/ml) ACA-IgG odds ratio [OR] 1.70, 95% CI: 1.01-2.93, p=0.047; high titre (>40 U/ml) ACA-IgG OR 4.60, 95% CI:1.02–20.8, p=0.047). Both ACA-IgM (OR 2.04, 95% CI: 1.4-3.0, p<0.0001) and ACA-IgG (OR 1.84, 95% CI: 1.2-2.8, p=0.005) were associated with interstitial lung disease (ILD). Increasing ACA-IgM and IgG titres were associated with increased likelihood of ILD. ACA-IgG was a marker of coexistent pulmonary hypertension and ILD (ILD-PH) (OR 2.10, 95% CI: 1.1-4.2, p=0.036). We also found an association between ACA-IgG and digital ulcers (OR 1.76, 95% CI: 1.16-2.67, p=0.008) and ACA-IgM and Raynaud`s phenomenon (OR 2.39, 95% CI: 1.08-5.27, p=0.031). There was no association between APLA and SSc disease subtype, peak skin score, presence of other autoantibodies, mortality or other disease manifestations. CONCLUSIONS: The association of APLA with PAH, ILD, ILD-PH, Raynaud`s phenomenon and digital ulcers suggests that endothelial abnormalities and small vessel thrombosis may be important in the pathogenesis of these disease features.
Keywords: Humans; Hypertension, Pulmonary; Lung Diseases, Interstitial; Heart Diseases; Raynaud Disease; Scleroderma, Systemic; Hand Dermatoses; Skin Ulcer; Immunoglobulin G; Immunoglobulin M; Antibodies, Antiphospholipid; Antibodies, Anticardiolipin; Logistic Models; Cohort Studies; Prospective Studies; Aged; Middle Aged; Female; Male
Rights: Copyright status unknown
RMID: 0030017668
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