1887
  1. الرئيسية
  2. A-Z Publications
  3. Qatar Medical Journal
  4. المجلد 2007, العدد 2
  5. المقالة
Volume 2007, Issue 2
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

ملخص

Objectives: The aims of the study are to determine the role of anti-phospholipid autoantibodies (APLAs) among patients with stroke and/or transient ischaemic attacks (TIAs), to identify the types and effective isotype of some important APLAs which are lupus anticoagulant (LA), anticardiolipin (aCL), anti∼fi2 glycoprotein I dependent (afi2-GPI), and anti-phosphatidyl serine (aPS). Also, to find out any concomitant effect of non-APLAparameters not specific to antiphospholipid syndrome (APS).

Subjects and Methods: This study was carried out on 50 patients attending mainly the Teaching and General Hospitals in Mosul, Duhok, and Erbil Cities, Iraq during the period between 1st March 2004 and 1st March 2005. The studied cases were under 50 years of age, and had no recognizable risk factors. The activated partial thromboplastin time (APTT) was used for LA estimation and ELISA assay was used to test for IgG& IgM isotypes ofaCL, aJ32-GPI, and aPS. The ANA, RF, VDRL, CRP, and C4 complement were tested by different immuoserological methods. The thrombocytopenic (TP) status was diagnosed by estimation of platelets counts.

Results: The strokes and!or TIAs related to APS were diagnosed in 22/50 (44%) of patients and a significant correlation was reported among patients with IgG plus IgM aCL (p <  0.05), IgG afi2-GPI (p <  0.05), and IgG aPS (p <  0.05). In APLAs positive patients, raised CRP concentrations were reported in 36.4%, TP status in 22.7%, ANA in 22.7%, RF positive in 13.6%, and low C4 levels in l3.6%. Finally,the FP-VDRL test was found in 50 % of APLAs positive cases.

Conclusions: The aCL, afi2- GPI, and aPS antibodies were shown to play a significant role in the development of stroke and!or TIAs among the studied cases.

© 2007 Ali, Abdullah, licensee Bloomsbury Qatar Foundation Journals.
Loading

جارٍ تحميل قياسات المقالة...

/content/journals/10.5339/qmj.2007.2.15
٢٠٠٧-١١-٠١
٢٠٢٤-٠٧-١٨
Loading full text...

Full text loading...

References

  1. Shapiro SS. The lupus anticoagulant/antiphospholipid syndrome. Annu Rev Med. 1996; 47::533–553.
     [Google الباحث العلمي]
  2. Roudey RA. Immunology of the antiphospholipid antibody syndrome. Arthritis Rheum. 1996; 39::1444–1454.
     [Google الباحث العلمي]
  3. Asherson RA, Khamashta MA, Ordis-Ros J, Derksen RH, Machin SJ. The “primary” antiphospholipid syndrome: Major clinical and serological features. Medicine (Baltimore). 1989; 68::366–374.
     [Google الباحث العلمي]
  4. Alarcon-Segovia D, Sanchez-Guerrero J. Primary antiphospholipid syndrome. J Rheumatol. 1989; 16::482–488.
     [Google الباحث العلمي]
  5. Alarcon-Segovia D, Deleze M, Oria CV, Sanchez-Guerrero J, Gomez-Pacheco . Antiphospholipid antibodies and the antiphospholipid syndrome in systemic lupus erythematosus A prospective analysis of500 consecutive patients. Medicine (Baltimore). 1989; 68::353–365.
     [Google الباحث العلمي]
  6. Hughes GR. Hugh s syndrome: the antiphospholipid syndrome. A historical view. Lupus. 1998; 7:Suppl 2:1384–1353, si -4. 353.
     [Google الباحث العلمي]
  7. Kumar KS, Prakash MS, Jyothy A. B2-Glycoprotein I dependent anticardiolipin antibodies in women experiencing recurrent pregnancy loss. JHG. 2002; 2:1:65–67.
     [Google الباحث العلمي]
  8. McNeil HP, Simpson RJ, Chesterman CN, Krilis SA. Anti-phospholipid antibodies are directed against a complex antigen that includes a lipid-binding inhibitor of coagulation: beta 2-glycoprotein I (apolipoprotein H). Proc Natl Acad Sci USA. 1990; 87::4120–4124.
     [Google الباحث العلمي]
  9. Loeliger A. Prothrombin as co-factor of the circulating anticoagulant in systemic lupus erythematosus. Thromb Diath Hemorrh. 1995; 3::237–256.
     [Google الباحث العلمي]
  10. Bevers EM, Galli M, Barbui T, et al., Lupus anticoagulant IgG (LA) are not directed to phospholipids only, but to a complex of lipid-bound human prothrombin. Thromb Hemost. 1991; 66::629–632.
     [Google الباحث العلمي]
  11. Kandiah DA, Krilis SA. Beta 2-glycoprotein I. Lupus. 1994; 3::207–212.
     [Google الباحث العلمي]
  12. Triplett DA. Protean clinical presentation of antiphospholipid-protein antibodies (APA). Thromb Hemost. 1995; 74::329–337.
     [Google الباحث العلمي]
  13. Lopez-Soto A, Cerver AR, Font J, et al., Isotype distribution and clinical significance of antibodies to cardiolipin, phosphatadic acid, phosphotidylinositol and phosphatidylserine in systemic lupus erthymatosus: prospective analysis of a series of 92 patients. Clin Exp Immunol. 1997; 15::143–149.
     [Google الباحث العلمي]
  14. Rauch J, Janoff AS. Antibodies against phospholipids other than cardiolipin: potential role for both phospholipid and protein. Lupus. 1996; 5::498–502.
     [Google الباحث العلمي]
  15. Gatenby PA. Controversies in the antiphospholipid syndrome and stroke. Thrombosis Research. 2004; 114::483–488.
     [Google الباحث العلمي]
  16. Weingarten K, Filippi C, Barbut D, Zimmerman RD. The neuroimaging features of the cardiolipin antibody syndrome. Clin Imaging. 1997; 21::6–12, (Abstract).
     [Google الباحث العلمي]
  17. Armitage P. Statistical method in medical research, 4th printing. Oxford, London, UK: Blackwell 1974:p.106.
     [Google الباحث العلمي]
  18. Martinuzzo ME, Maclouf J, Carreras LO, et al., Antiphospholipid antibodies enhance thrombin-induced platelet activation and thromboxane formation. Thromb Haemost. 1993; 70::667–671.
     [Google الباحث العلمي]
  19. Roubey RA. Mechanisms of autoantibody-mediated thrombosis. Lupus. 1998; 7:suppl2:S114–S119.
     [Google الباحث العلمي]
  20. Sletens KE, Smith P, Abdelnoor M, et al., Antiphospholipid antibodies after myocardial infarction and their relation to mortality, reinfarction, and non-hemorrhagic stroke. Lancet. 1992; 339::451–453.
     [Google الباحث العلمي]
  21. Ahmed L, Stegmayer B, Trifunovic J, et al., Anticardiolipin antibodies are not an independent risk factor fro stroke. Stroke. 2000; 31::1289–1293.
     [Google الباحث العلمي]
  22. Ginsburg PS, Liang MH, Newcomer L, et al., Anticardiolipin antibodies and the risk for ischemic stroke and venous thrombosis. Ann Intern Med. 1992; 117::997–1002.
     [Google الباحث العلمي]
  23. Brey RL, Hart RG, Sherman DG, Tegeler CH. Antiphospholipid antibodies in cerebral ischemia in young people. Neurology. 1990; 40::1190–1196.
     [Google الباحث العلمي]
  24. Brey RL, Abbott RD, Curb JD, et al., Beta(2) Glycoprotein I-dependent anticardiolipin antibodies and risk of ischemia stroke and myocardial infarction: the Honolulu heart program. Stroke. 2001; 32::1701–1706.
     [Google الباحث العلمي]
  25. Janaradhan V, Wolf PA, Kase CS, et al., Anticardiolipin antibodies and risk of ischemic stroke and transient ischemic attack. Stroke. 2004; 35::736–741.
     [Google الباحث العلمي]
  26. Cabral AR, Amigo MC, Cabiedes J, Alarcon-Segovia D. The antiphospholipid/cofactor syndromes: A primary variant with antibodies to fi2-glycoprotein I but no antibodies detectable in standard antiphospholipid assays. Am J Med. 1996; 101::472–481.
     [Google الباحث العلمي]
  27. Cuadrado MJ, Mujic F, Munoz E, et al., Thrombocytopenia in the antiphospholipid syndrome. Ann Rheum Dis. 1997; 56::194–196.
     [Google الباحث العلمي]
  28. Snow den N, Wilson PB, Long son M, et al., Antiphospholipid antibodies and Mycoplasma pneumoniae infection. Postgrad Med J. 1990; 66::356–362.
     [Google الباحث العلمي]
  29. Picillo U, Marcialis MR, Italiano G. Antibodies to fi2-glycoprotein I in anticardiolipin negative patients. J Rheumatol. 1998; 25::1440–1442.
     [Google الباحث العلمي]
  30. Salemink , Blezer R, Willems GM, et al., Antibodies to J32-glycoprotein I associated with antiphospholipid syndrome suppress the inhibitory activity to tissue factor pathway inhibitor. Thromb Haemost. 2000; 84::653–656.
     [Google الباحث العلمي]
  31. Lutters BCH, Derksen RHWM, Tekelenburg WL, et al., Dimers of _2-glycoprotein I increase platelet deposition to collagen via interaction with phospholipids and the apolipoprotien E receptor 2. J Biol Chem. 2003; 278::33831–33838.
     [Google الباحث العلمي]
  32. Galli M, Luciani D, Bertolini G, Barbui T. Antifi2-glycoprotein I and anti-prothrombin antibodies and the risk of thrombosis in the antiphospholipid syndrome. Blood. 2003; 102::2717–2723.
     [Google الباحث العلمي]
  33. Tuhrim S, Rand JH, Wu K, et al., Elevated anticardiolipin antibody titer is a stroke risk factor in multiethnic population independent of isotype or degree of positivity. Stroke. 1999; 30::1561–1565.
     [Google الباحث العلمي]
  34. Toschi V, Motta A, Castelli C, et al., Prevalence and clinical significance of antiphospholipid antibodies to noncardiolipin in systemic lupus erythematosus. Hemostasis. 1993; 23::275–283.
     [Google الباحث العلمي]
  35. Finazzi G, Cortelazzo S, Galli M, Barbui T. Relative risk of recurrent abortion and thrombosis in young subjects with antiphospholipid antibodies estimated by case-control studies [abstract]. Postgrad Med J. 1989; 65::697.
     [Google الباحث العلمي]
  36. Bongard O, Rebber G, Bounameaux H, de Moerloose P. Anticardiolipin antibodies in acute venous thromboembolism. Thromb Haemost. 1992; 67::724.
     [Google الباحث العلمي]
  37. WARSS (The World Antiphospholipid Antibodies Research Stroke Study Group) and GENESIS Study Group. The feasibility of collaborative double-blind study using an anticoagulant. Cerebrovasc Dis. 1997; 7::100–122.
     [Google الباحث العلمي]
  38. Macchi L, Rispal R, Colfent-Sanchez G, et al., Antiplatelets antibodies in patients with systemic lupus erthyematosus and the primary antiphospholipid antibody syndrome: their relationship with the observed thrombocytopenia. Br J Haematol. 1997; 98::336–341.
     [Google الباحث العلمي]
  39. Panzer S, Gschwandtner ME, Hutter D, et al., Specificities of platelets autoantibodies in patients with lupus anticoadulant in primary antiphospholipid syndrome. Ann Hematol. 1997; 74::239–242.
     [Google الباحث العلمي]
  40. Salmon JE. Complement activation as a mediator of antiphospholipid antibody induced pregnancy loss and thrombosis. Ann Rheum Dis. 2002; 61::ii46–ii50.
     [Google الباحث العلمي]
  41. Mujic F, Cuadrado MJ, Lioyd M, et al., Primary antiphospholipid syndrome evolving into systemic lupus erythematosus. J Rheumatol. 1995; 22::1589–1592.
     [Google الباحث العلمي]
  42. Pope JM, Canny CLB, Bell DA. Cerebral ischemia events associated with endocarditis, retinal vascular disease, and lupus anticoagulant. Am J Med. 1991; 90::299–309.
     [Google الباحث العلمي]
  43. Rost NS, Wolf PA, Kase CS, et al., Plasma concentration of C-reactive protein and risk of ischemic stroke and transient ischemic attack: The Framinghan study. Stroke. 2001; 32::2575–2579.
     [Google الباحث العلمي]
  44. Montalban J, Condina A, Ordit J, et al., Antiphospholipid antibodies in cerebral ischemia. Stroke. 1991; 22::750–753.
     [Google الباحث العلمي]
  45. Vero P, Levine SR, Tietjen GE. Cerebrovascular ischemic events with high positive anticardiolipin antibodies. Stroke. 1998; 29::2245–2253.
     [Google الباحث العلمي]
  46. APASS (The Antiphospholipid Antibodies in Stroke Study Group). Antiphospholipid antibodies and subsequent thrombo-occlusive events in patients with ischemic stroke. JAMA. 2004; 291::576–584.
     [Google الباحث العلمي]
/content/journals/10.5339/qmj.2007.2.15
Loading
  • نوع المستند: Research Article
الموضوعات الرئيسية Anti-phospholipid antibodies and stroke and/or TIAs

الأكثر اقتباسًا لهذا الشهر Most Cited RSS feed

هذه الخانة مطلوبة
يُرجى إدخال عنوان بريد إلكتروني صالح
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error