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The association of antiphospholipid antibodies with cardiopulmonary manifestations of systemic sclerosis

Citation

Morrisroe, KB and Stevens, W and Nandurkar, H and Prior, D and Thakkar, V and Roddy, J and Zochling, J and Sahhar, J and Tymms, K and Sturgess, A and Major, G and Kermeen, F and Hill, C and Walker, J and Nash, P and Gabbay, E and Youssef, P and Proudman, SM and Nikpour, M, The association of antiphospholipid antibodies with cardiopulmonary manifestations of systemic sclerosis, Clinical and Experimental Rheumatology, 32, (Suppl 86) pp. S133-S137. ISSN 0392-856X (2014) [Refereed Article]


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Copyright Statement

Copyright 2014 Clinical and Experimental Rheumatology

Official URL: http://www.clinexprheumatol.org/abstract.asp?a=742...

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.

Item Details

Item Type:Refereed Article
Keywords:scleroderma; pulmonary hypertension; antiphospholipid antibodies
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Rheumatology and Arthritis
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Skeletal System and Disorders (incl. Arthritis)
Author:Zochling, J (Dr Jane Zochling)
ID Code:96993
Year Published:2014
Web of Science® Times Cited:8
Deposited By:Menzies Institute for Medical Research
Deposited On:2014-11-27
Last Modified:2017-11-03
Downloads:0

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