Department of Laboratory Haematology, Austin Hospital, Melbourne, VIC, Australia.
Int J Lab Hematol. 2021 Oct;43(5):1225-1228. doi: 10.1111/ijlh.13492. Epub 2021 Feb 15.
The antiphospholipid syndrome (APS) is characterized by thrombosis or pregnancy morbidity, and the detection in the blood of at least one of three antiphospholipid antibodies (lupus anticoagulant, or anticardiolipin or anti-β -glycoprotein I antibodies). Diagnosing APS is important so that secondary prophylaxis may be administered to reduce risk of recurrent thrombosis and/or pregnancy morbidity. In addition to APS-defining antibodies, there may be additional autoantibodies that have a role in thrombosis and/or pregnancy morbidity. Furthermore, some patients have clinical manifestations highly suggestive of APS but are persistently negative for the APS-defining antibodies ("seronegative APS") and instead, have other autoantibodies. Antiannexin A5 (aANXA5) autoantibodies have been associated with increased risk of thrombosis and pregnancy morbidity; levels are also reportedly higher in patients with venous thrombosis compared with healthy controls. The prevalence of aANXA5 among patients with unprovoked venous thrombosis is not well-documented and determination of the frequency of aANXA5 is the objective of this study.
We analysed sera from 148 patients with unprovoked venous thrombosis who had undergone routine laboratory testing for the present APS-defining antibodies.
aANXA5 IgG and IgM were present in 6% and 1%, respectively.
Prevalence of these antibodies in unprovoked venous thrombosis is comparable with frequencies reported in healthy individuals and is far lower than the prevalence in women with pregnancy morbidity. This may indicate lack of association with venous thrombosis, however, adequately powered case-control studies will be required to resolve this and prevalence data from this study will assist in the design of such studies.
抗磷脂综合征(APS)的特征是血栓形成或妊娠发病,并且血液中至少检测到三种抗磷脂抗体(狼疮抗凝物、抗心磷脂或抗β-糖蛋白 I 抗体)中的一种。诊断 APS 很重要,以便进行二级预防,以降低复发性血栓形成和/或妊娠发病的风险。除了 APS 定义性抗体外,可能还有其他自身抗体在血栓形成和/或妊娠发病中起作用。此外,一些患者具有高度提示 APS 的临床表现,但持续 APS 定义性抗体阴性(“血清阴性 APS”),而是具有其他自身抗体。抗膜联蛋白 A5(aANXA5)自身抗体与血栓形成和妊娠发病风险增加相关;据报道,与健康对照组相比,静脉血栓形成患者的水平也更高。未诱发的静脉血栓形成患者中 aANXA5 的患病率尚未得到很好的记录,确定 aANXA5 的频率是本研究的目的。
我们分析了 148 例未诱发的静脉血栓形成患者的血清,这些患者已经进行了常规实验室检查以确定目前的 APS 定义性抗体。
aANXA5 IgG 和 IgM 的存在率分别为 6%和 1%。
这些抗体在未诱发的静脉血栓形成中的患病率与在健康个体中报道的频率相当,远低于妊娠发病的女性中的患病率。这可能表明与静脉血栓形成缺乏关联,然而,需要进行充分的病例对照研究来解决这个问题,并且本研究的患病率数据将有助于此类研究的设计。