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Review : Anti-endothelial cell antibodies in systemic autoimmune diseases: prevalence and clinical significance

Systemic Autoimmune Diseases Unit, Hospital Clinic

R. Cervera

Systemic Autoimmune Diseases Unit, Hospital Clinic

J. Font

Systemic Autoimmune Diseases Unit, Hospital Clinic

JC Reverter

Department of Hemotherapy and Hemostasis, Hospital Clinic, Barcelona, Catalonia, Spain

J. Monteagudo

Department of Hemotherapy and Hemostasis, Hospital Clinic, Barcelona, Catalonia, Spain

G. Escolar

Department of Hemotherapy and Hemostasis, Hospital Clinic, Barcelona, Catalonia, Spain

A. López-Soto

Systemic Autoimmune Diseases Unit, Hospital Clinic

A. Ordinas

Department of Hemotherapy and Hemostasis, Hospital Clinic, Barcelona, Catalonia, Spain

M. Ingelmo

Systemic Autoimmune Diseases Unit, Hospital Clinic

Objective: To investigate the prevalence and characteristics of anti-endothelial cell antibodies (AECA) in a large cohort of patients with several well defined systemic autoimmune diseases, in order to determine their relationship with the clinical and laboratory features of these diseases.

Methods: Clinical and laboratory features of 216 consecutive Caucasian patients were prospectively studied. One hundred and seven patients had been diagnosed as having a primary systemic vasculitis-specifically, 39 had temporal arteritis (TA), 25 polyarteritis nodosa (PAN), 9 Wegener's granulomatosis (WG), and 34 Behçet's disease (BD)-, 90 patients had systemic lupus erythematosus (SLE), and 19 had a primary Sjögren's syndrome (SS). The AECA were determined by ELISA.

Results: One hundred and four (48%) patients with systemic autoimmune diseases were found to have a positive titre of AECA. Specifically, AECA were detected in 41 (38%) patients with a primary systemic vasculitis (13 (33%) with TA, 14 (56%) with PAN, 5 (56%) with WG and 9 (26%) with BD), in 58 (63%) patients with SLE, and in 5 (26%) patients with a primary SS. In patients with a primary systemic vasculitis, those with AECA were found to have an increased prevalence of disease activity (P < 0.05). In SLE patients, those with AECA were found to have an increased prevalence of vascular lesions (P < 0.05), lupus nephropathy (P < 0.05), and antic ardiolipin antibodies (aCL) (P < 0.001).

Conclusions: Patients with systemic autoimmune diseases have a high prevalence of AECA and they are associated with the presence of vascular lesions, nephropathy, and aCL in SLE, as well as with disease activity in several primary systemic vasculitis (TA, PAN, WG and BD).

Key Words: anti-endothelial cell antibodies • systemic vasculitis • systemic lupus erythematosus • antiphospholipid antibodies

Lupus, Vol. 6, No. 6, 521-526 (1997)
DOI: 10.1177/096120339700600608


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