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Intractable headaches, ischemic stroke, and seizures are linked to the presence of anti-β2GPI antibodies in patients with systemic lupus erythematosus.

Hawro T, Bogucki A, Krupińska-Kun M, Maurer M, Woźniacka A - PLoS ONE (2015)

Bottom Line: Headaches and ischemic stroke were independently associated with anti-β2GPI-IgM (OR=5.6; p<0.05), and seizures were linked to anti-β2GPI-IgG (OR=11.3; p=0.01).Autoantibodies to β2GPI are linked to non-specific headaches, ischemic stroke and seizures, and show a better predictive value than aCL and LA.These findings may help to improve the diagnosis of NPSLE and should prompt further studies to characterize the role of anti-β2GPI in the pathogenesis of this condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.

ABSTRACT

Background: Neuropsychiatric systemic lupus erythematosus (NPSLE) is a common and potentially fatal manifestation of SLE. Antiphospholipid antibodies (aPL) such as lupus anticoagulant (LA), anticardiolipin (aCL) and antibodies to β2glycoprotein I (anti-β2GPI), the most important aPL antigen, are thought to play a role in some forms of NPSLE. As of yet, their specific roles in NPSLE manifestations remain to be elucidated.

Methodology/principal findings: 57 SLE patients (53 women) were assessed for LA, aCL and anti-β2GPI twice, to determine persistent positivity. All patients were examined by neurology and psychiatry specialists. 69 healthy subjects were assessed as controls. NPSLE was diagnosed in 74% of patients. Headaches were the most prevalent manifestation of NPSLE (39%), followed by cerebrovascular disease (CVD) (23%), depressive disorders (19.0%), and seizures (14%). NPSLE and non-NPSLE patients showed comparable SLE activity and corticosteroid use. In 65% of patients neuropsychiatric manifestations preceded SLE diagnosis. aPL profiles of NPSLE patients and non-NPSLE patients were similar. Headaches and ischemic stroke were independently associated with anti-β2GPI-IgM (OR=5.6; p<0.05), and seizures were linked to anti-β2GPI-IgG (OR=11.3; p=0.01).

Conclusions: In SLE patients, neuropsychiatric manifestations occur frequently and early, often before the disease is diagnosed. Autoantibodies to β2GPI are linked to non-specific headaches, ischemic stroke and seizures, and show a better predictive value than aCL and LA. These findings may help to improve the diagnosis of NPSLE and should prompt further studies to characterize the role of anti-β2GPI in the pathogenesis of this condition.

No MeSH data available.


Related in: MedlinePlus

Comparison of systemic lupus erythematosus (SLE) activity, as measured with the Systemic Lupus Activity Measure (SLAM), in patients with and without cerebrovascular diseases.Median values expressed as horizontal lines, interquartile ranges as boxes, and ranges as whiskers.
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pone.0119911.g002: Comparison of systemic lupus erythematosus (SLE) activity, as measured with the Systemic Lupus Activity Measure (SLAM), in patients with and without cerebrovascular diseases.Median values expressed as horizontal lines, interquartile ranges as boxes, and ranges as whiskers.

Mentions: The mean disease activity in our SLE patients was 11.3 ± 6.0, range 3–34, as assessed by SLAM. We did not find a significant difference in the mean SLE activity between NPSLE and non-NPSLE patients. The only NPSLE subgroup that exhibited increased disease activity was patients with cerebrovascular diseases (CVD): median disease activity in these patients was significantly higher (13.0; lower quartile 10.5, upper quartile 19.0) than in patients without cerebrovascular diseases (10.0; lower quartile 6.0, upper quartile 14.0; p<0.05) (Fig. 2). We did not observe any statistically significant differences in the frequency of ACR criteria for SLE between NPSLE and non-NPSLE patients (Table 2). The mean current daily corticosteroid dose of all patients was 11.2 ± 13.8 mg (range 0–60 mg), and the mean life cumulative corticosteroid dose was 25.4 ± 32.3 g (range 0–123 g). There was no difference between NPSLE and non-NPSLE groups in corticosteroid doses, neither current nor cumulative.


Intractable headaches, ischemic stroke, and seizures are linked to the presence of anti-β2GPI antibodies in patients with systemic lupus erythematosus.

Hawro T, Bogucki A, Krupińska-Kun M, Maurer M, Woźniacka A - PLoS ONE (2015)

Comparison of systemic lupus erythematosus (SLE) activity, as measured with the Systemic Lupus Activity Measure (SLAM), in patients with and without cerebrovascular diseases.Median values expressed as horizontal lines, interquartile ranges as boxes, and ranges as whiskers.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4362944&req=5

pone.0119911.g002: Comparison of systemic lupus erythematosus (SLE) activity, as measured with the Systemic Lupus Activity Measure (SLAM), in patients with and without cerebrovascular diseases.Median values expressed as horizontal lines, interquartile ranges as boxes, and ranges as whiskers.
Mentions: The mean disease activity in our SLE patients was 11.3 ± 6.0, range 3–34, as assessed by SLAM. We did not find a significant difference in the mean SLE activity between NPSLE and non-NPSLE patients. The only NPSLE subgroup that exhibited increased disease activity was patients with cerebrovascular diseases (CVD): median disease activity in these patients was significantly higher (13.0; lower quartile 10.5, upper quartile 19.0) than in patients without cerebrovascular diseases (10.0; lower quartile 6.0, upper quartile 14.0; p<0.05) (Fig. 2). We did not observe any statistically significant differences in the frequency of ACR criteria for SLE between NPSLE and non-NPSLE patients (Table 2). The mean current daily corticosteroid dose of all patients was 11.2 ± 13.8 mg (range 0–60 mg), and the mean life cumulative corticosteroid dose was 25.4 ± 32.3 g (range 0–123 g). There was no difference between NPSLE and non-NPSLE groups in corticosteroid doses, neither current nor cumulative.

Bottom Line: Headaches and ischemic stroke were independently associated with anti-β2GPI-IgM (OR=5.6; p<0.05), and seizures were linked to anti-β2GPI-IgG (OR=11.3; p=0.01).Autoantibodies to β2GPI are linked to non-specific headaches, ischemic stroke and seizures, and show a better predictive value than aCL and LA.These findings may help to improve the diagnosis of NPSLE and should prompt further studies to characterize the role of anti-β2GPI in the pathogenesis of this condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.

ABSTRACT

Background: Neuropsychiatric systemic lupus erythematosus (NPSLE) is a common and potentially fatal manifestation of SLE. Antiphospholipid antibodies (aPL) such as lupus anticoagulant (LA), anticardiolipin (aCL) and antibodies to β2glycoprotein I (anti-β2GPI), the most important aPL antigen, are thought to play a role in some forms of NPSLE. As of yet, their specific roles in NPSLE manifestations remain to be elucidated.

Methodology/principal findings: 57 SLE patients (53 women) were assessed for LA, aCL and anti-β2GPI twice, to determine persistent positivity. All patients were examined by neurology and psychiatry specialists. 69 healthy subjects were assessed as controls. NPSLE was diagnosed in 74% of patients. Headaches were the most prevalent manifestation of NPSLE (39%), followed by cerebrovascular disease (CVD) (23%), depressive disorders (19.0%), and seizures (14%). NPSLE and non-NPSLE patients showed comparable SLE activity and corticosteroid use. In 65% of patients neuropsychiatric manifestations preceded SLE diagnosis. aPL profiles of NPSLE patients and non-NPSLE patients were similar. Headaches and ischemic stroke were independently associated with anti-β2GPI-IgM (OR=5.6; p<0.05), and seizures were linked to anti-β2GPI-IgG (OR=11.3; p=0.01).

Conclusions: In SLE patients, neuropsychiatric manifestations occur frequently and early, often before the disease is diagnosed. Autoantibodies to β2GPI are linked to non-specific headaches, ischemic stroke and seizures, and show a better predictive value than aCL and LA. These findings may help to improve the diagnosis of NPSLE and should prompt further studies to characterize the role of anti-β2GPI in the pathogenesis of this condition.

No MeSH data available.


Related in: MedlinePlus