Summary
The prevalence of anticardiolipin antibodies in active systemic lupus erythematosus (SLE) was compared with that in inactive SLE and other rheumatic and non-rheumatic diseases to determine the value of these autoantibodies in monitoring rheumatic diseases. Pairs of IgG- and IgM-aCL were measured by ELISA in 173 consecutive hospitalised patients, including 141 with rheumatic diseases (18 active SLE, 21 inactive SLE, 19 rheumatoid arthritis, 13 reactive arthritis, 7 other spondyloarthropathies, 16 vasculitis, 47 other autoimmune diseases) and 32 non-rheumatic controls. A further 101 aCL pairs were determined during follow-up in 19 patients with SLE. Serum concentrations were analysed with respect to SLE activity and compared between the different patient groups. IgG- and IgM-aCL levels in excess of 10 GPL and 9 MPL respectively were considered positive. 30.6% of all patients (53/173) were found to be positive for IgG-aCL, as against only 9.8% (17/173) for IgM-aCL. IgG-aCL serum levels in active SLE differed significantly from all other groups, including inactive SLE (all p<0.005). Median IgM-aCL levels were below the cut off point in all groups, although measurable values were obtained almost exclusively in active SLE and RA. In this study IgM-aCL measurement was of less value in monitoring rheumatic diseases. IgG-aCL positivity in SLE was associated with a significantly higher odds ratio (OR) for active disease (OR 16.0, 95% confidence interval: 2.8–90.0). The results show that disease activity in SLE was accompanied by significantly increased IgG-aCL, whereas no elevation was found in other diseases. This parameter may therefore be useful in monitoring SLE activity.
Similar content being viewed by others
References
Tsakiris DA, de Moerloose P. Antiphospholipid syndrome: a new clinical entity? Schweiz Med Wochenschr 1993;123:2183–90.
Fort GJ, Cowchock FS, Abruzzo JL et al. Anticardiolipin antibodies in patients with rheumatic diseases. Arthritis Rheum 1987; 30: 752–60.
Sturfelt G, Nived O, Norberg R et al. Anticardiolipin antibodies in patients with systemic lupus erythematosus. Arthritis Rheum 1987; 30: 382–8.
Doria A, Ruffatti A, Calligaro A et al. Antiphospholipid antibodies in mixed connective tissue disease. Clin Rheumatol 1992; 11:48–50.
Jedryka-Goral A, Jagiello P, D'Cruz DP et al. Isotype profile and clinical relevance of anticardiolipin antibodies in Sjögren's syndrome. Ann Rheum Dis 1992; 51: 889–91.
Cooper RC, Klemp P, Stipp CJ, Brink S. The relationship of anticardiolipin antibodies to disease activity in systemic lupus erythematosus. Br J Rheumatol 1989; 28: 379–82.
Nossent JC, Henzen-Logmans SC, Vroom TM et al. Relation between serological data at the time of biopsy and renal histology in lupus nephritis. Rheumatol Int 1991; 11: 77–82.
Ishii Y, Nagasawa K, Mayumi T, Niho Y. Clinical importance of persistence of anticardiolipin antibodies in systemic lupus erythematosus. Ann Rheum Dis 1990; 49: 387–90.
Alarcon-Segóvia D, Deleze M, Oria CV et al. Antiphospholipid antibodies and the antiphospholipid syndrome in systemic lupus erythematosus. A prospective analysis of 500 consecutive patients. Medicine 1989; 68: 353–65.
Tan EM, Cohen AA, Fries JF et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1992; 25: 1271–7.
Zonana-Nacach A, Salas M, Sánchez L et al. Measurements of clinical activity of systemic lupus erythematosus and laboratory abnormalities: A 12-month prospective study. J Rheumatol 1995; 22: 45–9.
Vitali C, Bencivelli W, Isenberg DA et al. Disease activity in Systemic Lupus Erythematosus: Report of the Consensus Study Group of the European Workshop for Rheumatology Research. II. Identification of the variables indicative of disease activity and their use in the development of an activity score. The European Consensus Study Group for Disease Activity in SLE. Clin Exp Rheumatol 1992; 10: 541–47.
Arnett FC, Edworthy SM, Bloch DE et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31: 315–24.
Dougados M, van der Linden S, Juhlin R et al. The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum 1991; 34: 1218–27.
Fleiss JL. Statistical methods for rates and proportions. 2nd edition. Wiley, 1981.
Dawson-Saunders B, Trapp RG. Basic and clinical biostatistics. Appleton & Lange, 1990.
Hughes GRV. The antiphospholipid syndrome: ten years on. Lancet 1993; 342: 341–4.
Ginsburg KS, Liang MH, Newcomer L et al. Anticardiolipin antibodies and the risk for ischemic stroke and venous thrombosis. Ann Int Med 1992; 117: 997–1002.
Muri KW, Squire IB, Alwan W, Lees KR. Anticardiolipin antibodies in an unselected stroke population. Lancet 1994; 344: 452–6.
Vlachoyiannopoulos PG, Krilis SA, Hunt JE et al. Patients with anticardiolipin antibodies with and without antiphospholipid syndrome: their clinical features and β2-glycoprotein-I plasma levels. Eur J Clin Inv 1992; 22: 482–7.
Drenkard C, Villa AR, Alarcon-Segóvia D, Pèrez-Vàzquez ME. Influence of the antiphospholipid syndrome in the survival of patients with systemic lupus erythematosus. J Rheumatol 1994; 21: 1067–72.
Asherson RA, Baguley E, Pal C, Hughes GRV. Antiphospholipid syndrome: five year follow up. Ann Rheum Dis 1991; 50: 805–10.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Buttgereit, F., Grünewald, T., Schüler-Maué, W. et al. Value of anticardiolipin antibodies for monitoring disease activity in systemic lupus erythematosus and other rheumatic diseases. Clin Rheumatol 16, 562–569 (1997). https://doi.org/10.1007/BF02247796
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02247796