It is known that the presence of some non- criteria antiphospholipid anibodies (n-c aPL) is connected with thrombosis and pregnancy complications. Some n-c aPL are considered as significant for diagnosis of primary antiphospholipid syndrome (pAPS).
The aim of the study was to determine the prevalence of non-criteria antiphospholipid anibodies in a group of patients with pAPS
The study involved 26 (16 f,10 m) of APS patients (pts) observed for a longterm in a University Clinic. All pts fulfilled the criteria for classification of APS . The mean age of the pts was: 40,81± 13,42 (range 18-66), the duration of the disease was 9,2 ± 8,83 years (range 1-37).
The presence of Ab was detected in patients’ serum using the commercially available tests: aPL-immunodot assay Anti-Phospholipid 10 Dot, for the qualitative detection of IgG or IgM antibodies. Statistical data analysis was performed using Statistica v13.0
N-c aPL were detected relatively often in p APS pts (a-phosphatidylserine IgG 65.4% of pts; a-prothrombin IgM 57,7%). A-prothrombin IgM were detected significantly more often than a a-CL IgM and a a-phosphatydylserin IgG were detected significantly more often than a a-B2GPI IgG.
The clinical symptoms observed in the pts are: thrombosis 69,2%; stroke 30,8%; pulmonary embolism 30,8%; pregnancy complications 26,7%, migraine 26,9%, livedo reticularis 69,2%, infarct 15,4% and seizures 7,7%. Migraine, seizures and pregnancy complications significantly correlated with some n-c aPL.
N-c aPL can be a valuable tool for accurate diagnosis of p APS and my help in making an appropriate decision concerning the treatment
Pregnant women with autoimmune diseases (AIDs) have higher probabilities of maternal and fetal complications. AIDs have a variable behavior during pregnancy: while some improve, others remain stable and several worsen with associated poor obstetric and perinatal outcomes. The aim of this study was to describe AIDs and obstetric outcomes in pregnant women.
This is a retrospective study carried out between 2011-2020 in Cali, Colombia. Pregnant women with diagnosis of AIDs were included. Demographic, clinical and laboratory features, as well as obstetric and fetal outcomes including intensive care unit (ICU) characteristics were evaluated.
Fifty-six pregnant women with AIDs were included. Mean age was 29.6 (4.9%) years. Fourty-eight (85.7%) patients had Systemic Lupus Erythematosus (SLE), of which five had polyautoimmunity; six (10.7%) had antiphospholipid syndrome; one (1.8%) rheumatoid arthritis, and one (1.8%) inflammatory myopathies. Diagnosis was made before pregnancy in 41 (73.2%) with an average duration of disease of 56.6 (53.9) months. Of SLE patients, 13/48(27.1%) presented lupus nephritis. Preterm labor (38, 67.9%), preeclampsia (28, 50%), prelabor rupture of membranes (11, 19.6%), were the most common complications. Twenty-two (39.3%) patients required ICU; 40,9% of them due to AID activity, 27.3% for cardiovascular damage, 9.1% for septic shock, and 9,1% for acute kidney failure. Fetal survival was 80.4% (N=45/56). Two were diagnosed with neonatal lupus and two with congenital heart block. One maternal death was registered due to preeclampsia and intraventricular hemorrhage.
This is the first description of AIDs during pregnancy in Colombia.
Primary sjögren’s syndrome (pSS) is a chronic, systemic autoimmune disease characterized by lymphocytic infiltration of exocrine glands, which resulted in functional impairment of salivary and lachrymal glands. Although the complement system has been implicated in the pathogenesis of SS, the exact underlying mechanisms still remain poorly understood. The present study aims to investigate the pathogenesis of pSS by detecting the levels of C5a and C5b-9 in the plasma and labial gland specimens of patients with pSS.
The diagnosis was made according to 2017 American College of Rheumatology–European League against Rheumatism classification criteria for primary sjögren’s syndrome. Plasma levels of C5a, and C5b-9 were examined by enzyme linked immunosorbent assay in 60 pSS patients and 30 healthy controls. The expressions of C5a and C5b-9 were detected by immunohistochemistry on sections of labial salivary gland from 40 pSS patients and 10 control subjects.
Plasma levels of C5a and C5b-9 were significantly increased in pSS patients when compared to healthy controls. In addition, plasma levels of C5a were significantly positively correlated with plasma C5b-9. Notably, enhanced expressions of C5a and C5b-9 were found in labial salivary gland biopsy specimens of pSS patients when compared to controls.
Our findings suggested that extensive complement C5 activation is involved in the occurrence and development of pSS. Complement C5 might be a therapeutic target to control the progression of pSS.