Abu-Shakra M, Gladman DD, Urowitz MB, Farewell V
Anticardiolipin antibodies in systemic lupus erythematosus: clinical and laboratory correlations

Am J Med (Dec) 99:624-628 1995

A prospective cohort study in a single center examined the link between anticardiolipin antibodies and features of the antiphospholipid syndrome (thrombocytopenia, prolonged PTT, positive direct Coombs test, arterial and venous thrombosis, spontaneous abortions, vasculitic skin ulcers, livedo reticularis, and renal disease) in SLE patients. 47% of patients had an elevated antibody level; its presence correlated with laboratory but not clinical features of the antiphospholipid syndrome. Only prolonged aPTT was associated with thrombosis. Prolonged PTT should be used rather than elevated anticardiolipin antibodies for identifying SLE patients with a high risk of thrombosis. The link between prolonged PTT and thrombosis may indicate that only those antibodies with lupus anticaogulant activity are pathogenic. These results contrast with findings in patients with anticardiolipin antibodies without SLE (primary antiphospholipid syndrome), in whom the presence of antibodies is predictive of thrombosis. (Leehey)

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Proteinuria/Hematuria : Lupus nephritis