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The presence of IgG antibodies against β2‐glycoprotein I predicts the risk of thrombosis in patients with the lupus anticoagulant
Author(s) -
ZOGHLAMIRINTELEN C.,
VORMITTAG R.,
SAILER T.,
LEHR S.,
QUEHENBERGER P.,
RUMPOLD H.,
MALE C.,
PABINGER I.
Publication year - 2005
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/j.1538-7836.2005.01394.x
Subject(s) - lupus anticoagulant , thrombosis , antibody , medicine , immunology , glycoprotein , anticoagulant , biology , microbiology and biotechnology
Summary. Background: Lupus anticoagulant (LA) is a strong risk factor of thrombosis. However, a subgroup of patients positive for LA is unaffected by thrombosis and currently no predictive markers are available to identify patients positive for LA at increased risk for thrombosis. Objective: The aim of the study was to investigate whether anti‐beta‐2‐glycoprotein I (anti‐ β 2GPI) or anticardiolipin antibodies (ACA) are associated with an increased risk of thrombosis in patients persistently positive for LA. Patients and methods: A cohort of 87 consecutive patients persistently positive for LA was investigated, 55 with and 32 without a history of thrombosis. Immunoglobulin G (IgG) and M (IgM) antibodies against β 2GPI and cardiolipin were determined by enzyme‐linked immunoassay. Results: Patients positive for LA with thrombosis had significantly higher levels of anti‐ β 2GPI IgG (median 16.7 standard units, interquartile range 3.0–75.2, P = 0.002) and of ACA IgG (41.1 IgG phospholipid units per mL, 8.9–109.0, P = 0.002) than those without thrombosis (2.6, 1.4–7.9 and 9.7, 4.6–22.1, respectively). Levels of anti‐ β 2GPI IgM and ACA IgM did not differ significantly between LA patients with and without thrombosis ( P = 0.25 and 0.12, respectively). Elevated anti‐ β 2GPI IgG was associated with an increased risk for thrombosis (OR = 4.0, 95% CI 1.2–13.1), especially for venous thromboembolism (OR = 5.2, 95% CI 1.5–18.0). Conclusions: Increased levels of anti‐ β 2GPI IgG were associated with thrombosis. We conclude that anti‐ β 2GPI IgG levels above normal predict an increased risk of thrombosis in patients persistently positive for LA.