Skip to main content
PMC home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1990 Feb;49(2):109–113. doi: 10.1136/ard.49.2.109

Isotype distribution of anticardiolipin antibodies in systemic lupus erythematosus: prospective analysis of a series of 100 patients.

R Cervera 1, J Font 1, A López-Soto 1, F Casals 1, L Pallarés 1, A Bové 1, M Ingelmo 1, A Urbano-Márquez 1
PMCID: PMC1003989  PMID: 2107799

Abstract

A prospective study of IgG and IgM isotypes of anticardiolipin antibodies (aCL) in a series of 100 patients with systemic lupus erythematosus was carried out. To determine the normal range of both isotype titres a group of 100 normal control serum samples was studied and a log-normal distribution of IgG and IgM isotypes was found. The IgG anticardiolipin antibody serum was regarded as positive if a binding index greater than 2.85 (SD 3.77) was detected and a binding index greater than 4.07 (3.90) was defined as positive for IgM anticardiolipin antibody. Twenty four patients were positive for IgG aCL, 20 for IgM aCL, and 36 for IgG or IgM aCL, or both. IgG aCL were found to have a significant association with thrombosis and thrombocytopenia, and IgM aCL with haemolytic anaemia and neutropenia. Specificity and predictive value for these clinical manifestations increased at moderate and high anticardiolipin antibody titres. In addition, a significant association was found between aCL and the presence of lupus anticoagulant. Identification of these differences in the anticardiolipin antibody isotype associations may improve the clinical usefulness of these tests, and this study confirms the good specificity and predictive value of the anticardiolipin antibody titre for these clinical manifestations.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alarcón-Segovia D. Pathogenetic potential of antiphospholipid antibodies. J Rheumatol. 1988 Jun;15(6):890–893. [PubMed] [Google Scholar]
  2. Asherson R. A., Harris E. N. Anticardiolipin antibodies--clinical associations. Postgrad Med J. 1986 Dec;62(734):1081–1087. doi: 10.1136/pgmj.62.734.1081. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Asherson R. A., Mercey D., Phillips G., Sheehan N., Gharavi A. E., Harris E. N., Hughes G. R. Recurrent stroke and multi-infarct dementia in systemic lupus erythematosus: association with antiphospholipid antibodies. Ann Rheum Dis. 1987 Aug;46(8):605–611. doi: 10.1136/ard.46.8.605. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Boey M. L., Colaco C. B., Gharavi A. E., Elkon K. B., Loizou S., Hughes G. R. Thrombosis in systemic lupus erythematosus: striking association with the presence of circulating lupus anticoagulant. Br Med J (Clin Res Ed) 1983 Oct 8;287(6398):1021–1023. doi: 10.1136/bmj.287.6398.1021. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Colaço C. B., Male D. K. Anti-phospholipid antibodies in syphilis and a thrombotic subset of SLE: distinct profiles of epitope specificity. Clin Exp Immunol. 1985 Feb;59(2):449–456. [PMC free article] [PubMed] [Google Scholar]
  6. Cronin M. E., Biswas R. M., Van der Straeton C., Fleisher T. A., Klippel J. H. IgG and IgM anticardiolipin antibodies in patients with lupus with anticardiolipin antibody associated clinical syndromes. J Rheumatol. 1988;15(5):795–798. [PubMed] [Google Scholar]
  7. Delezé M., Oria C. V., Alarcón-Segovia D. Occurrence of both hemolytic anemia and thrombocytopenic purpura (Evans' syndrome) in systemic lupus erythematosus. Relationship to antiphospholipid antibodies. J Rheumatol. 1988 Apr;15(4):611–615. [PubMed] [Google Scholar]
  8. Derksen R. H., Hasselaar P., Blokzijl L., Gmelig Meyling F. H., De Groot P. G. Coagulation screen is more specific than the anticardiolipin antibody ELISA in defining a thrombotic subset of lupus patients. Ann Rheum Dis. 1988 May;47(5):364–371. doi: 10.1136/ard.47.5.364. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Font J., Cervera R., Casals F. J., Bové A., Guerrero A., López-Soto A., Ingelmo M., Urbano-Márquez A. Estudio de la relación de los anticuerpos antifosfolípidos con los fenómenos trombóticos y la actividad clínica del lupus eritematoso sistémico. Med Clin (Barc) 1988 Mar 26;90(12):490–493. [PubMed] [Google Scholar]
  10. Fort J. G., Cowchock F. S., Abruzzo J. L., Smith J. B. Anticardiolipin antibodies in patients with rheumatic diseases. Arthritis Rheum. 1987 Jul;30(7):752–760. doi: 10.1002/art.1780300705. [DOI] [PubMed] [Google Scholar]
  11. Gharavi A. E., Harris E. N., Asherson R. A., Hughes G. R. Anticardiolipin antibodies: isotype distribution and phospholipid specificity. Ann Rheum Dis. 1987 Jan;46(1):1–6. doi: 10.1136/ard.46.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Glueck H. I., Kant K. S., Weiss M. A., Pollak V. E., Miller M. A., Coots M. Thrombosis in systemic lupus erythematosus. Relation to the presence of circulating anticoagulants. Arch Intern Med. 1985 Aug;145(8):1389–1395. [PubMed] [Google Scholar]
  13. Green D., Hougie C., Kazmier F. J., Lechner K., Mannucci P. M., Rizza C. R., Sultan Y. Report of the Working Party on Acquired Inhibitors of Coagulation: studies of the "lupus" anticoagulant. Thromb Haemost. 1983 Apr 28;49(2):144–146. [PubMed] [Google Scholar]
  14. Harris E. N., Chan J. K., Asherson R. A., Aber V. R., Gharavi A. E., Hughes G. R. Thrombosis, recurrent fetal loss, and thrombocytopenia. Predictive value of the anticardiolipin antibody test. Arch Intern Med. 1986 Nov;146(11):2153–2156. [PubMed] [Google Scholar]
  15. Harris E. N., Gharavi A. E., Boey M. L., Patel B. M., Mackworth-Young C. G., Loizou S., Hughes G. R. Anticardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. Lancet. 1983 Nov 26;2(8361):1211–1214. doi: 10.1016/s0140-6736(83)91267-9. [DOI] [PubMed] [Google Scholar]
  16. Hazeltine M., Rauch J., Danoff D., Esdaile J. M., Tannenbaum H. Antiphospholipid antibodies in systemic lupus erythematosus: evidence of an association with positive Coombs' and hypocomplementemia. J Rheumatol. 1988 Jan;15(1):80–86. [PubMed] [Google Scholar]
  17. Isenberg D. A., Colaco C. B., Dudeney C., Todd-Pokropek A., Snaith M. L. The relationship of anti-DNA antibody idiotypes and anti-cardiolipin antibodies to disease activity in systemic lupus erythematosus. Medicine (Baltimore) 1986 Jan;65(1):46–55. doi: 10.1097/00005792-198601000-00003. [DOI] [PubMed] [Google Scholar]
  18. Khamashta M. A., Gil A., Anciones B., Lavilla P., Valencia M. E., Pintado V., Vázquez J. J. Chorea in systemic lupus erythematosus: association with antiphospholipid antibodies. Ann Rheum Dis. 1988 Aug;47(8):681–683. doi: 10.1136/ard.47.8.681. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Lockshin M. D., Druzin M. L., Goei S., Qamar T., Magid M. S., Jovanovic L., Ferenc M. Antibody to cardiolipin as a predictor of fetal distress or death in pregnant patients with systemic lupus erythematosus. N Engl J Med. 1985 Jul 18;313(3):152–156. doi: 10.1056/NEJM198507183130304. [DOI] [PubMed] [Google Scholar]
  20. Loizou S., McCrea J. D., Rudge A. C., Reynolds R., Boyle C. C., Harris E. N. Measurement of anti-cardiolipin antibodies by an enzyme-linked immunosorbent assay (ELISA): standardization and quantitation of results. Clin Exp Immunol. 1985 Dec;62(3):738–745. [PMC free article] [PubMed] [Google Scholar]
  21. Manoussakis M. N., Gharavi A. E., Drosos A. A., Kitridou R. C., Moutsopoulos H. M. Anticardiolipin antibodies in unselected autoimmune rheumatic disease patients. Clin Immunol Immunopathol. 1987 Sep;44(3):297–307. doi: 10.1016/0090-1229(87)90073-0. [DOI] [PubMed] [Google Scholar]
  22. Mueh J. R., Herbst K. D., Rapaport S. I. Thrombosis in patients with the lupus anticoagulant. Ann Intern Med. 1980 Feb;92(2 Pt 1):156–159. doi: 10.7326/0003-4819-92-2-156. [DOI] [PubMed] [Google Scholar]
  23. Ordi Ros J., Vilardell Tarrés M., Barquinero Máez J., Selva O'Callaghan A., Alijotas Reig J., Bosch Gil J. Fenómenos trombóticos y anticoagulante lúpico en una serie de 112 enfermos con lupus eritematoso sistémico. Rev Clin Esp. 1987 Feb;180(2):66–70. [PubMed] [Google Scholar]
  24. Petri M., Golbus M., Anderson R., Whiting-O'Keefe Q., Corash L., Hellmann D. Antinuclear antibody, lupus anticoagulant, and anticardiolipin antibody in women with idiopathic habitual abortion. A controlled, prospective study of forty-four women. Arthritis Rheum. 1987 Jun;30(6):601–606. doi: 10.1002/art.1780300601. [DOI] [PubMed] [Google Scholar]
  25. Petri M., Rheinschmidt M., Whiting-O'Keefe Q., Hellmann D., Corash L. The frequency of lupus anticoagulant in systemic lupus erythematosus. A study of sixty consecutive patients by activated partial thromboplastin time, Russell viper venom time, and anticardiolipin antibody level. Ann Intern Med. 1987 Apr;106(4):524–531. doi: 10.7326/0003-4819-106-4-524. [DOI] [PubMed] [Google Scholar]
  26. Scott J. R., Rote N. S., Branch D. W. Immunologic aspects of recurrent abortion and fetal death. Obstet Gynecol. 1987 Oct;70(4):645–656. [PubMed] [Google Scholar]
  27. Sturfelt G., Nived O., Norberg R., Thorstensson R., Krook K. Anticardiolipin antibodies in patients with systemic lupus erythematosus. Arthritis Rheum. 1987 Apr;30(4):382–388. doi: 10.1002/art.1780300404. [DOI] [PubMed] [Google Scholar]
  28. Tan E. M., Cohen A. S., Fries J. F., Masi A. T., McShane D. J., Rothfield N. F., Schaller J. G., Talal N., Winchester R. J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271–1277. doi: 10.1002/art.1780251101. [DOI] [PubMed] [Google Scholar]
  29. Weidmann C. E., Wallace D. J., Peter J. B., Knight P. J., Bear M. B., Klinenberg J. R. Studies of IgG, IgM and IgA antiphospholipid antibody isotypes in systemic lupus erythematosus. J Rheumatol. 1988 Jan;15(1):74–79. [PubMed] [Google Scholar]
  30. Wold R. T., Young F. E., Tan E. M., Farr R. S. Deoxyribonucleic acid antibody: a method to detect its primary interaction with deoxyribonucleic acid. Science. 1968 Aug 23;161(3843):806–807. doi: 10.1126/science.161.3843.806. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES