RESUMO
The aim of this study was to determine a possible association between recidivist superficial thrombophlebitis and anticardiolipin antibodies. Forty-five patients with two or more episodes of superficial thrombophlebitis in lower limbs (33 women and 12 men with ages ranging from 17 to 60 years, average: 39.8) were studied. The control group was formed by 100 voluntary donors from the blood bank (83 men and 17 women, age range: 21 to 59 years, average: 35.4). Anticardiolipin antibody concentrations were determined by enzyme-linked immunosorbent assay (ELISA). For semiquantitative detection in human sera with use of QUANTA Lite ACA IgG/IgM--INOVA Diagnostic, Inc., and positive values were considered as 15 GPL units/mL and 12.5 MPL units/mL for immunoglobulin G (IgG) and IgM, respectively, as recommended by the test. The Odds Ratio method was chosen for statistical analysis with a confidence interval (CI) of 95%. In 15 patients (33.3%) anticardiolipin antibody positivity was detected, whereas in 12 patients (26.7%) it occurred as immunoglobulin M (IgM) anticardiolipin and in 3 (6.7%) as immunoglobulin G anticardiolipin. In the control group, positivity was found in 7 patients (7%) for those antibodies. Furthermore, the Odds Ratio = 6.64 with CI = 95% and values ranging from 2.48 to 17.82 (p < 0.05) were significant, as well as for IgM/IgG anticardiolipin proportion with Odds Ratio = 5.09, C = 95% and values varying from 1.33 to 19.54 (p < 0.05). The authors conclude that there is a correlation between the presence of anticardiolipin antibodies and recurrent superficial thrombophlebitis.
Assuntos
Anticorpos Anticardiolipina/imunologia , Tromboflebite/imunologia , Adulto , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , RecidivaRESUMO
Defective fibrinolysis due to decreased tissue-type plasminogen activator (t-PA) activity is a well-established finding in patients with systemic lupus erythematosus (SLE). The possibility that this decrease in t-PA activity may be related to the presence of autoantibodies directed against t-PA, and the possible role of these autoantibodies in the pathophysiology of fibrinolysis in SLE, were investigated. Serum samples from 115 SLE patients and 63 normal volunteers were analyzed for the presence of such antibodies. The search for antibodies to t-PA was performed by means of several systems, allowing for the identification of epitopes presented in different conformational physical states of t-PA: free or associated to its inhibitor (PAI-1) in plasma, specifically bound to fibrin surface, or passively adsorbed to solid supports. Antibodies in variable amounts were detected by all systems used; however, t-PA activity was not inhibited by the IgG fraction of the positive sera in a fibrin-agar fibrinolysis system. Moreover, the demonstration of serum anti-t-PA antibodies was not associated with clinical or laboratory abnormalities related to vasoocclusive episodes. These results indicate that, as in the case of other autoantibodies, their detection in serum does not imply their direct participation in the pathophysiology of thrombosis in SLE.
Assuntos
Autoanticorpos/sangue , Epitopos/imunologia , Lúpus Eritematoso Sistêmico/imunologia , Ativador de Plasminogênio Tecidual/imunologia , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Immunoblotting , Lúpus Eritematoso Sistêmico/sangue , Masculino , Pessoa de Meia-Idade , Nefelometria e Turbidimetria , Tromboflebite/imunologiaRESUMO
Recently, the association between anti-phospholipid antibodies (false positive VDRL, lupus anticoagulant or anti-cardiolipin antibody) and diverse clinical manifestations has been termed antiphospholipid syndrome. We report 6 female patients with "primary" antiphospholipid syndrome, not related to connective tissue disorders. Their age ranged from 23 to 66 years and they were followed from 1 to 27 years (mean 9.2). Venous occlusion developed in 4, arterial occlusion in 4 (TIA, convulsive episode and cutaneous thrombotic microangiopathy). Three of 5 had fetal loss and 3/6 developed thrombocytopenia. Leg ulcer, migraine and mitral valvulopathy and peripheral facial paralysis were isolated manifestations in different patients. High titers for type IgG anticardiolipin antibodies were present in all patients. Low titers for IgM antibodies were present in 2. The pathogenesis of this syndrome is discussed.
Assuntos
Síndrome Antifosfolipídica/complicações , Adulto , Idoso , Anticoagulantes/uso terapêutico , Síndrome Antifosfolipídica/sangue , Síndrome Antifosfolipídica/diagnóstico , Feminino , Morte Fetal , Seguimentos , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Pessoa de Meia-Idade , Gravidez , Trombocitopenia/tratamento farmacológico , Trombocitopenia/imunologia , Tromboflebite/tratamento farmacológico , Tromboflebite/imunologiaAssuntos
Adulto , Pessoa de Meia-Idade , Humanos , Feminino , Fosfolipídeos/imunologia , Autoanticorpos/análise , Lúpus Eritematoso Sistêmico/complicações , Autoanticorpos/imunologia , Trombocitopenia/imunologia , Trombocitopenia/tratamento farmacológico , Tromboflebite/imunologia , Tromboflebite/tratamento farmacológico , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Seguimentos , Morte Fetal , Lúpus Eritematoso Sistêmico/sangue , Anticoagulantes/uso terapêutico , SíndromeRESUMO
A relationship between antiphospholipid antibodies (APLA) and thromboses has been proposed in patients with systemic lupus erythematosus (SLE). In most instances, however, the thromboocclusive episodes were historic and did not coincide with the study of APLA. We studied 6 patients with SLE who, having had sequential determinations with high levels of APLA, were found to have falls in them coincident with thromboocclusive episode(s) and not attributable to treatment. Because our patients had recurrent thrombotic episodes, higher previous and subsequent titers of APLA, and other manifestations that have been similarly proposed to associate with APLA, our observations may indicate consumption of the APLA in the course of the thromboocclusive episode.
Assuntos
Autoanticorpos/análise , Lúpus Eritematoso Sistêmico/imunologia , Fosfolipídeos/imunologia , Tromboflebite/imunologia , Adulto , Feminino , Humanos , Imunoglobulina G/análise , Imunoglobulina M/análise , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de TempoRESUMO
A relaçäo anticorpos anticardiolipina e aborto ou trombose é discutida em uma mulher de 28 anos que apresentou abortos repetidos e trombose venosa profunda. Doenças infecciosas, anormalidades, genéticas, distúrbios metabólicos e defeitos uterinos foram excluídos como causa dos abortos recorrentes. Embora a paciente näo mostrasse evidência clínica de lúpus eritematoso sistêmico, o teste ENA foi positivo e houve presença de níveis elevados de anticorpos anticardiolipina