This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (2) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Tarr, T. Articles by Kiss, E. Search for Related Content PubMed PubMed Citation Articles by Tarr, T. Articles by Kiss, E. Pubmed/NCBI databases Medline Plus Health Information Lupus Social Bookmarking                         What's this?

Primary antiphospholipid syndrome as the forerunner of systemic lupus erythematosus

Third Department of Internal Medicine, Clinical Immunology Division, University of Debrecen, Debrecen, Hungary

G. Lakos

Third Department of Internal Medicine, Clinical Immunology Division, University of Debrecen, Debrecen, Hungary

H.P. Bhattoa

Department of Clinical Biochemistry and Molecular Pathology, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary

G. Szegedi

Autoimmune Diseases Research Group of the Hungarian Academy of Sciences and University of Debrecen, Debrecen, Hungary

Y. Shoenfeld

Department of Medicine B and Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel

E. Kiss

Third Department of Internal Medicine, Clinical Immunology Division, University of Debrecen, Debrecen, Hungary, kiss{at}iiibel.dote.hu

The objective of this study was to analyse whether primary antiphospholipid syndrome (PAPS) may precede and modify the characteristics of systemic lupus erythematosus (SLE). Out of the total 362 SLE patients in our service, 223 patients had antiphospholipid antibodies (aPL), of whom 110 met the criteria of antiphospholipid syndrome. In 26 cases (7.2%) PAPS appeared 5.5 years before the onset of lupus (PAPS+SLE Group). Their clinical findings were compared to lupus patients without (SLE only Group, n = 26) and with secondary APS (SLE+SAPS Group, n = 26). The prevalence of deep venous thrombosis, stroke/TIA, recurrent fetal loss, coronary heart disease and myocardial infarction was significantly higher in PAPS+SLE Group as compared to SLE only Group. The difference in prevalence of fetal loss (P = 0.014) between PAPS+SLE and SLE+SAPS Groups was also recorded. On comparison to PAPS+SLE Group, patients without APS (SLE only Group) were younger at onset of lupus, with more frequent flares and a higher prevalence of WHO type III/IV nephritis (P = 0.007), requiring higher doses of cyclophosphamide and corticosteroids. Lupus started in the form of PAPS in 7.2% of our SLE patients, who presented with more thrombotic and less inflammatory complications than in SLE patients without a prior or with a following secondary APS. Considering the long latency between the two diseases, PAPS may be a forerunner of lupus, but it may also coexist with SLE as an independent autoimmune disorder. Lupus (2007) 16 , 324—328.

Key Words: association • PAPS • SLE

Lupus, Vol. 16, No. 5, 324-328 (2007)
DOI: 10.1177/0961203307077993


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				T Avcin, R Cimaz, B Rozman, and The Ped-APS Registry Collaborative Group* The Ped-APS Registry: the antiphospholipid syndrome in childhood Lupus, September 1, 2009; 18(10): 894 - 899. [Abstract] [PDF]

				K Anam, M Amare, S Naik, K. Szabo, and T. Davis Severe tissue trauma triggers the autoimmune state systemic lupus erythematosus in the MRL/++ lupus-prone mouse Lupus, April 1, 2009; 18(4): 318 - 331. [Abstract] [PDF]

				T. Avcin, R. Cimaz, E. D. Silverman, R. Cervera, M. Gattorno, S. Garay, Y. Berkun, F. R. Sztajnbok, C. A. Silva, L. M. Campos, et al. Pediatric Antiphospholipid Syndrome: Clinical and Immunologic Features of 121 Patients in an International Registry Pediatrics, November 1, 2008; 122(5): e1100 - e1107. [Abstract] [Full Text] [PDF]