Karmochkine M, Cacoub P, Piette J C, Godeau P, Boffa M C
INSERM 353, Hopital Saint-Louis, Paris, France.
Clin Exp Rheumatol. 1992 Nov-Dec;10(6):603-5.
A previously healthy 34-year-old woman, was diagnosed as having systemic lupus erythematosus (SLE), with membranous glomerulopathy which improved rapidly. Neither lupus anticoagulant nor anticardiolipin antibodies were detected in her plasma. After three months of total remission, she developed a severe pulmonary thromboembolism for which no specific biological cause was found. Her plasma was analysed for different antiphospholipid antibodies: lupus anticoagulant and anticardiolipin antibodies were again negative. Using an ELISA prepared with either five different anionic phospholipids or zwitterionic phosphatidylethanolamine, solely an anti-phosphatidylethanolamine IgG was discovered in her plasma. In lupus patients, the presence of antiphospholipid antibodies is now well recognized as a high risk factor for repeated thrombosis and/or recurrent abortions. This case suggests that the presence of antiphosphatidylethanolamine antibody should be investigated in cases of unexplained thrombosis in SLE, where the usual clinical and biological investigations have failed to shed light.
一名34岁既往健康的女性被诊断为系统性红斑狼疮（SLE），伴有膜性肾小球病，病情迅速好转。其血浆中未检测到狼疮抗凝物和抗心磷脂抗体。在完全缓解三个月后，她发生了严重的肺血栓栓塞，未发现特定的生物学病因。对其血浆进行了不同抗磷脂抗体分析：狼疮抗凝物和抗心磷脂抗体再次呈阴性。使用由五种不同阴离子磷脂或两性离子磷脂酰乙醇胺制备的酶联免疫吸附测定（ELISA），仅在其血浆中发现了抗磷脂酰乙醇胺IgG。在狼疮患者中，抗磷脂抗体的存在现已被公认为是反复血栓形成和/或反复流产的高风险因素。该病例表明，在SLE患者出现无法解释的血栓形成且常规临床和生物学检查未能明确病因时，应调查抗磷脂酰乙醇胺抗体的存在情况。
