Association of Lupus Anticoagulant With Long‐Term Damage Accrual in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

Objective Antiphospholipid antibodies (aPL) are frequently present in antineutrophil cytoplasmic antibody–associated vasculitis (AAV) patients; however, the prognostic impact of aPL in such patients has not been elucidated. The objective of this study was to determine whether persistent aPL positivi...

Full description

Saved in:
Bibliographic Details
Published in:Arthritis care & research (2010) 2016-05, Vol.68 (5), p.711-715
Main Authors: Jordan, Natasha, D'cruz, David P.
Format: Article
Language:English
Subjects:
Adult
Aged
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - blood
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - immunology
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - pathology
Antibodies, Anticardiolipin - blood
Antibodies, Anticardiolipin - immunology
Antibodies, Antineutrophil Cytoplasmic - blood
Antibodies, Antineutrophil Cytoplasmic - immunology
Antibodies, Antiphospholipid - blood
Antibodies, Antiphospholipid - immunology
Anticoagulants
Antineutrophil cytoplasmic antibodies
Antiphospholipid antibodies
Antiphospholipid syndrome
Antiphospholipid Syndrome - blood
Antiphospholipid Syndrome - immunology
Autoimmune diseases
Blood Vessels - immunology
Blood Vessels - pathology
Cardiolipin
Diagnosis
Female
Humans
Immunoglobulin G
Immunoglobulin G - blood
Immunoglobulin G - immunology
Immunoglobulin M
Immunoglobulin M - blood
Immunoglobulin M - immunology
Lupus
Lupus Coagulation Inhibitor - blood
Lupus Coagulation Inhibitor - immunology
Male
Middle Aged
Retrospective Studies
Severity of Illness Index
Systemic lupus erythematosus
Time
Vasculitis
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective Antiphospholipid antibodies (aPL) are frequently present in antineutrophil cytoplasmic antibody–associated vasculitis (AAV) patients; however, the prognostic impact of aPL in such patients has not been elucidated. The objective of this study was to determine whether persistent aPL positivity in AAV patients was associated with increased long‐term damage accrual. Methods Clinical data were retrospectively collected on all AAV patients who attended the vasculitis clinic at our center over a 4‐year period. Data collection included presence of lupus anticoagulant (LAC) and IgG and IgM anticardiolipin (aCL) antibody titers, along with concurrent diagnosis of antiphospholipid syndrome (APS). Accumulation of long‐term damage was quantified using the Vasculitis Damage Index (VDI). Results Data from 116 AAV patients were analyzed. A total of 34% (n = 40) had persistently positive aCL or LAC or a concurrent diagnosis of APS and were classified as AAV/aPL. A total of 76 patients (66%) were classified as AAV alone. LAC was present in a statistically higher proportion of AAV/aPL patients than those in the AAV‐alone group (P < 0.0001). Mean VDI score was significantly higher in the AAV/aPL group at mean ± SD 3.54 ± 1.36 as compared to 1.96 ± 1.42 in the AAV‐alone group (P < 0.0001). Major vascular damage scores were significantly higher in the AAV/aPL group, with mean ± SD 0.32 ± 0.59 as compared to 0.07 ± 0.26 in the AAV‐alone group (P < 0.007). Conclusion Persistently positive occurrence of aPL, in particular LAC, is present in a significant proportion of AAV patients and is associated with a higher VDI score. Clinicians should consider screening AAV patients for aPL.
ISSN:2151-464X
2151-4658
DOI:10.1002/acr.22723