Background: Antiphospholipid Syndrome (APS) is an autoimmune disorder characterized by venous/arterial thrombotic events and pregnancy morbidity in presence of pathogenic autoantibodies known as antiphospholipid antibodies (APL). APS is often associated with systemic autoimmune diseases, especially with Systemic Lupus Erythematous (SLE), being part of the latest criteria of SLE. ¹

Objectives: The aim of this study was to evaluate the impact of Antiphospholipid syndrome in patients with Systemic Lupus Erythematous presented at our Rheumatology Clinic at University Hospital Center Mother Teresa in Tirana, Albania.

Methods: This is an observational case-control study which included patients diagnosed with SLE from 16-51 years old, presented at our clinic during the period from 10 December 2014-10 September 2019.

Seventy-three patients with SLE were included in the study. Patients were classified according to the presence of Antiphospholipid Syndrome or not, according to the current guidelines. The case study (patients with SLE and APS) consisted in 24 patients, and the control group consisted in 49 patients. Besides the usual laboratory tests (complete blood count, erythrosedimentation rate, C3, C4 complement fractions, urinalysis and 24h proteinuria, c-reactive protein), all patients underwent immunological tests for anti-nuclear antibodies, anti-DNA antibodies and antiphospholipid antibodies (Anti-cardiolipin IgM and IgG). If APL were found positive, according to EULAR recommendations, tests were repeated after 12 weeks. Female patients were asked about their pregnancy history and their possible miscarriages/aborts.

Results: After our statistical analysis it resulted that there is a significant difference between C3 complement fraction (patients with APS and SLE tend to have more hypocomplementemia than the other group) (p= 0.006). Thrombocytopenia resulted to be an important feature, statistically significant in the cases’ group (p= 0.003). It was seen a statistically significant difference referring to the number of miscarriages/aborts in the history of female patients with APS and SLE in comparison to those with SLE without APS (p= 0.03). Proteinuria it has a tendency to be more marked in patients with APS and SLE, with a significant difference in comparison to the controls (p= 0.04).

Conclusion: In this study was seen that patients with antiphospholipid Syndrome and Systemic Lupus Erythematous tend to have more hypocomplementemia C3, and thrombocytopenia. It resulted a statistically significant relationship with miscarriages or aborts in patients with APS and SLE in comparison to SLE patients. It was seen a significant tendency to have marked proteinuria in patients with SLE and APS compared to controls.

Through this study it was seen a characteristic clinical and laboratory picture that may be useful in the identification of cases with APS in patients with SLE, in their follow-up and treatment.

REFERENCES:

[1]Miyakis S, Lockshin MD, Atsumi T, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). Thromb Haemost 2006;4: 295–306.

Disclosure of Interests: None declared