Abstract
Antiphospholipid antibodies (aPL) are common as a predictive variable for autoimmunity related miscarriages. However, it is controversial whether antinuclear antibody (ANA)-positive patients should be treated with any medication, because it is unclear whether ANAs are in fact pathogenic. The present study focuses on the possible association betweenβ2 glycoprotein IQ32GPI) dependent anticardiolipin antibody (aCL), lupus anticoagulant (LA) and ANA and the clinical significance of ANA in patients with recurrent miscarriages. We have studied 301 patients with a history of two or more miscarriages. β2GPI dependent aCL were measured by the ELISA method. LA was detected by the dilute aPTT method. ANAs were measured by indirect immunofluorescence on Hep-2 cell slides. We also studied the subsequent pregnancy outcome in 225 patients with a history of two consecutive first-trimester abortions, focusing on ANA. None of the 225 patients had aPL and received any medication or immunotherapy. The prevalence of β2GPI dependent aCL, LA and ANA were 3.3% (10 of 301), 10.0% (30 of 301) and 25.2% (76 of 301), respectively. Four of 301 patients had all antibodies. Regarding ANA in 225 patients with a history of two miscarriages, 39 of the 225 (17.3%) patients had ANAs, as compared with 33 of 740 (4.5%) control women. The prevalence of ANA in patients was significantly higher than that of controls (p < 0.001, Odds Ratio = 4.49). Forty-nine of the 225 (21.8%) recurrent aborters suffered a further abortion, the figures for ANA-negative and ANA-positive patients being 23.1% (43 of 186) and 15.4% (6 of 39) respectively (no significant difference).
β2GPI dependent aCL, LA and ANA define three distinct but partly related populations. ANA is associated in some way with miscarriage, but ANA-positive recurrent aborters with no evidence of aPL do not require medication because the presence of antibodies does not predict subsequent pregnancy loss.p
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Ogasawara, M., Aoki, K., Katano, K., Aoyama, T., Suzumori, K. (1999). Clinical Significance of β2 Glycoprotein I Dependent Anticardiolipin Antibody, Lupus Anticoagulant and Antinuclear Antibodies in Patients with Recurrent Miscarriages. In: Gupta, S.K. (eds) Reproductive Immunology. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-4197-0_28
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DOI: https://doi.org/10.1007/978-94-011-4197-0_28
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