Antiphospholipid Antibodies: Analysis

There were 23 cases in which abnormal chest x-ray film findings disappeared within 2 years, but 23 cases in which these findings persisted for over 2 years. The aPL frequency was 13 percent (3 of 23) in the former group and 65 percent (15 of 23) in the latter. Nine cases not included in this analysis were either cases in which observations were made for fewer than 2 years or cases which were diagnosed as stage 0 on the first visit. The data demonstrate a significantly higher aPL frequency in the group with abnormal findings for more than 2 years (p<0.01), as seen in Table 2.
Thirty-one cases were observed, this time for more than 5 years. In 16 of them, abnormal findings disappeared within 5 years, but persisted in the other 15 for more than 5 years. The frequency of aPL was 19 percent (3 of 16) in the former group and 73 percent (11 of 15) in the latter. other Thus, aPL occurred significantly more often in the group with abnormal findings for more than 5 years (p<0.01), as seen in Table 2.
The 21 who were aPL-positive among the 55 sarcoidosis patients were divided into 3 groups according to the immunoglobulin classes which were found: IgG aPL only (5 cases), IgM aPL only (11 cases), and both IgG and IgM aPL (5 cases) (Table 1). No significant relationships were found among the three groups and any of the clinical manifestations investigated. However, comparing the cases with IgG aPL with the cases with IgM aPL (irrespective of presence or absence of another immunoglobulin class), those with IgM aPL showed a persistence of abnormal chest x-ray film findings for more than 2 years and for more than 5 years (p<0.05). The aPL against anionic phospholipid (especially anticardiolipin antibody) frequently has been detected in serum from patients with systemic lupus erythematosus or other connective tissue diseases. The presence of aPL confers an increased risk of arterial and venous thrombosis, recurrent spontaneous fetal loss, and thrombocytopenia.
Recently, it has been postulated that there are two kinds of aPL; one associated with infections including syphilis, the other with autoimmune disease such as systemic lupus erythematosus.19-21 The aCL associated with autoimmune disease (autoimmune type) is reported to require the presence of glycoprotein I (/82GPI) to bind cardiolipin, whereas aPL with infections (infective type) can bind cardiolipin without foGPI, indicating that these two types of antibodies are different from each other with regard to their binding sites.19-25 Autoimmune type aCL recognizes 182GPI complexed to cardiolipin, whereas the infective type is directed against a specific phospholipid component only.

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