bjectives : The antiphospholipid antibodies (APA) are associated with a clinical syndrome
of vascular thrombosis, thrombocytopenia, recurrent fetal loss and neurological manifestations.
This has been studied by several investigators for systemic lupus erythematosus but no
systematic study has been reported for the correlation between a variety of systemic
rheumatic diseases including rheumatoid arthritis and antiphospholipid antibodies in Korea.
Methods : Authors have used enzyme-linked immunosorbent assay (ELISA) to detect
antibodies to phospholipids and studied the frequencies of antibodies to these antigens and
their correlation with clinical and laboratoray features in systemice rheumatic diseases.
Results :
1) 206 patients were investigated for the presence of antibodies to phopholipids and 25 out
of 206 patients (12.1%) had antiphospholipid antibodies.
2) The frequencies of antibodies to phospholipids were 20.7% in patients with systemic
lupus erythematosus, 12.3% in rheumatoid arthritis and 16.7% in mixed connective tissue
dsease but antibodies to phospholipids were not detected in ankylosing spondylitis,
polymyositis/dermatomyositis, undifferentiated connective tissue disease and Behcet's disease.
3) In patients with systemic lupus erythematosus, no significant association was found
between antiphospholipid antibodies and clinical and laboratory features except
thrombocytopenia and anti-Ro antibody (p=0.003, p=0.036). But patients with antiphospholipid
antibodies were likely to have a higher incidence of malar rash, photosensitivity, alopecia,
neurologic manifestation, renal disorder, fetal loss and thrombosis than those without
antiphospholipid antibodies.
4) In patients with rheumatoid arthritis, no significant association was found between
antiphospholopid antibodies and clinical and laboratory features.
Conclusions : These results showed that the detedtion of antibodies to phospholipids by
ELISA was expected to be useful as a screening test and suggested that antiphospholipid
antibody found in rheumatoid arthritis patients differed from that seen in systemic lupus
erythematosus patients. Further studies into the fine specificity of antiphospholipid antibody in
various systemic rheumatic diseases ara needed.
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