The association of antiphospholipid antibodies with cardiopulmonary manifestations of systemic sclerosis

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dc.contributor.authorMorrisroe, K.
dc.contributor.authorStevens, W.
dc.contributor.authorNandurkar, H.
dc.contributor.authorPrior, D.
dc.contributor.authorThakkar, V.
dc.contributor.authorRoddy, J.
dc.contributor.authorZochling, J.
dc.contributor.authorSahhar, J.
dc.contributor.authorTymms, K.
dc.contributor.authorSturgess, A.
dc.contributor.authorMajor, G.
dc.contributor.authorKermeen, F.
dc.contributor.authorHill, C.
dc.contributor.authorWalker, J.
dc.contributor.authorNash, P.
dc.contributor.authorGabbay, E.
dc.contributor.authorYoussef, P.
dc.contributor.authorProudman, S.
dc.contributor.authorNikpour, M.
dc.date.issued2014
dc.description.abstractOBJECTIVES: To determine the prevalence and correlates of antiphospholipid antibodies (APLA) in systemic sclerosis (SSc). METHODS: Nine hundred and forty SSc patients were tested for APLA using an ELISA assay at recruitment. Clinical manifestations were defined as present, if ever present from SSc diagnosis. Logistic regression analysis was used to determine the associations of APLA. RESULTS: One or more types of APLA were present in 226 (24.0%) patients. Anticardiolipin (ACA) IgG (ACA-IgG) antibodies were associated with right heart catheter-diagnosed pulmonary arterial hypertension (PAH), with higher titres corresponding with a higher likelihood of PAH (moderate titre (20-39 U/ml) ACA-IgG odds ratio [OR] 1.70, 95% CI: 1.01-2.93, p=0.047; high titre (>40 U/ml) ACA-IgG OR 4.60, 95% CI:1.02–20.8, p=0.047). Both ACA-IgM (OR 2.04, 95% CI: 1.4-3.0, p<0.0001) and ACA-IgG (OR 1.84, 95% CI: 1.2-2.8, p=0.005) were associated with interstitial lung disease (ILD). Increasing ACA-IgM and IgG titres were associated with increased likelihood of ILD. ACA-IgG was a marker of coexistent pulmonary hypertension and ILD (ILD-PH) (OR 2.10, 95% CI: 1.1-4.2, p=0.036). We also found an association between ACA-IgG and digital ulcers (OR 1.76, 95% CI: 1.16-2.67, p=0.008) and ACA-IgM and Raynaud`s phenomenon (OR 2.39, 95% CI: 1.08-5.27, p=0.031). There was no association between APLA and SSc disease subtype, peak skin score, presence of other autoantibodies, mortality or other disease manifestations. CONCLUSIONS: The association of APLA with PAH, ILD, ILD-PH, Raynaud`s phenomenon and digital ulcers suggests that endothelial abnormalities and small vessel thrombosis may be important in the pathogenesis of these disease features.
dc.description.statementofresponsibilityK. Morrisroe, W. Stevens, H. Nandurkar, D. Prior, V. Thakkar, J. Roddy, J. Zochling, J. Sahhar, K. Tymms, A. Sturgess, G. Major, F. Kermeen, C. Hill, J. Walker, P. Nash, E. Gabbay, P. Youssef, S. Proudman, M. Nikpour
dc.identifier.citationClinical and Experimental Rheumatology, 2014; 32(6 Suppl. 86):S133-S137
dc.identifier.issn1593-098X
dc.identifier.issn1593-098X
dc.identifier.orcidHill, C. [0000-0001-8289-4922]
dc.identifier.orcidProudman, S. [0000-0002-3046-9884]
dc.identifier.urihttp://hdl.handle.net/2440/95413
dc.language.isoen
dc.publisherPacini editore
dc.rightsCopyright status unknown
dc.source.urihttp://www.clinexprheumatol.org/abstract.asp?a=7423
dc.subjectHumans
dc.subjectHypertension, Pulmonary
dc.subjectLung Diseases, Interstitial
dc.subjectHeart Diseases
dc.subjectRaynaud Disease
dc.subjectScleroderma, Systemic
dc.subjectHand Dermatoses
dc.subjectSkin Ulcer
dc.subjectImmunoglobulin G
dc.subjectImmunoglobulin M
dc.subjectAntibodies, Antiphospholipid
dc.subjectAntibodies, Anticardiolipin
dc.subjectLogistic Models
dc.subjectCohort Studies
dc.subjectProspective Studies
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.titleThe association of antiphospholipid antibodies with cardiopulmonary manifestations of systemic sclerosis
dc.typeJournal article
pubs.publication-statusPublished

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