Figueroa F, Berríos X, Gutiérrez M, Carrión F, Goycolea J P, Riedel I, Jacobelli S
Departamento de Inmunología Clínica y Reumatología, Pontificia Universidad Católica de Chile, Santiago.
J Rheumatol. 1992 Aug;19(8):1175-80.
Recent reports describe the association of antiphospholipid antibodies (aPL) with chorea or severe heart valve lesions in systemic lupus erythematosus, lupus-like disease, or the primary antiphospholipid antibody syndrome. We conducted a case series and a case-control investigation of patients with rheumatic fever with Sydenham chorea or other manifestations of rheumatic fever for anticardiolipin antibodies (aCL) during the acute attack and disease remission. Eighty percent of patients were positive for aCL during the rheumatic fever attack vs 40% when inactive (p = 0.035); IgG and IgM aCL increased significantly with disease activity. Individuals with or without Sydenham chorea were equally positive for aCL (76 and 83%, respectively). A significant association was found between IgM aCL and carditis: All patients with valvulitis had IgM aCL (100%) vs 37% of patients without valvular involvement (p = 0.02). aPL may play a role in the pathogenesis of some clinical manifestations of acute rheumatic fever.
近期报告描述了抗磷脂抗体（aPL）与系统性红斑狼疮、狼疮样疾病或原发性抗磷脂抗体综合征中的舞蹈病或严重心脏瓣膜病变之间的关联。我们对患有风湿热伴Sydenham舞蹈病或风湿热其他表现的患者进行了病例系列研究和病例对照调查，以检测急性发作期和疾病缓解期的抗心磷脂抗体（aCL）。80%的患者在风湿热发作期aCL呈阳性，而病情不活动时为40%（p = 0.035）；IgG和IgM aCL随疾病活动度显著增加。有或无Sydenham舞蹈病的个体aCL阳性率相当（分别为76%和83%）。发现IgM aCL与心脏炎之间存在显著关联：所有患瓣膜炎症的患者IgM aCL均呈阳性（100%），而无瓣膜受累的患者为37%（p = 0.02）。aPL可能在急性风湿热某些临床表现的发病机制中起作用。
