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The correlation between lupus anticoagulant and autoantibodies
N Gleicher1, L Harlow, A el-Roeiy
1Department of Obstetrics and Gynecology, Mount Sinai Hospital Medical Center, Chicago, IL.
The Mount Sinai Journal of Medicine, New York
|January 1, 1992
Summary
A positive lupus anticoagulant (LA) is linked to reproductive failure. This study found a weaker correlation between LA and autoantibodies, including antiphospholipid antibodies, than previously suggested, recommending broader autoantibody screening.
Area of Science:
- Immunology
- Reproductive Medicine
- Clinical Chemistry
Background:
- A positive lupus anticoagulant (LA) has been associated with reproductive failure and autoantibody abnormalities.
- The correlation between LA and autoantibody positivity, particularly antiphospholipid autoantibodies, remains controversial.
- Previous studies suggest a strong link, necessitating further investigation into the nuances of this relationship.
Purpose of the Study:
- To investigate the correlation between lupus anticoagulant (LA) and various autoantibodies in patients with reproductive failure.
- To analyze these correlations separately for IgG, IgM, and IgA isotypes.
- To clarify the extent of association between LA and antiphospholipid antibodies versus other autoantibodies.
Main Methods:
- Retrospective analysis of 326 sera from patients diagnosed with reproductive failure.
- Assessment of lupus anticoagulant (LA) using TTI and APTT assays.
- Quantification of 15 autoantibodies across IgG, IgM, and IgA isotypes, including antiphospholipid, histone, and antipolynucleotide antibodies.
Main Results:
- Significant correlation was observed between LA (by TTI and APTT) and several autoantibody isotypes (p < 0.0001).
- Antiphospholipid, histone, and antipolynucleotide autoantibodies showed varying degrees of correlation with LA assay methods.
- Correlation was less pronounced in LA-positive sera and primarily associated with IgG and IgA isotypes, with a weaker link to IgM, especially at abnormal LA levels.
Conclusions:
- The correlation between LA and autoantibodies, particularly antiphospholipid antibodies, is less pronounced than commonly reported.
- A comprehensive autoantibody profile screening is recommended for patients with reproductive failure and suspected autoimmunity, beyond just LA and selected antiphospholipid antibodies.