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  • Title: [Clinical relevance of the antiphospholipid syndrome. Antiphospholipid antibodies in a mixed rheumatologic patient sample].
    Author: Kühne C, Keitel W, Flach W.
    Journal: Fortschr Med; 1994 Oct 30; 112(30):423-6. PubMed ID: 7806118.
    Abstract:
    The antiphospholipid syndrome may occur either in association with systemic lupus erythematosus (SLE) or as a primary condition. Diagnostic criteria include the detection of antiphospholipid antibodies using cardiolipin antigen (anticardiolipin antibodies, ACA) or lupus anticoagulant, and at least two clinical manifestations, primarily venous or arterial thrombosis, thrombocytopenia or repeated miscarriage. Among 200 patients with various rheumatic diseases, a pathological ACA test in excess of 44 U/ml was detected with ELISA in 81 cases (41%), and of these 30% had values exceeding 100 U/ml. Both overall positive reactions and the particularly high titers were clearly more common among patients with rheumatoid arthritis (RA) and collagen disease, namely 51% and 33%, respectively, than in patients with sero-negative spondylarthritis and non-inflammatory diseases of the locomotory system (22% pathological, 13% highly pathological, titers. Correlations were also found with miscarriage in women, positive rheumatoid and antinuclear factors, and the number of diagnostic criteria of RA or SLE presenting. A questionnaire survey - evaluating 84 subjects, half with positive and half with negative, ACA reactions - confirmed the correlation between miscarriage and the detection of ACA.
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