Details

Autor(en) / Beteiligte

• Hawro, Tomasz
• Bogucki, Andrzej
• Krupinska-Kun, Maria
• Maurer, Marcus
• Woźniacka, Anna

Titel

Intractable Headaches, Ischemic Stroke, and Seizures Are Linked to the Presence of Anti-[beta]2GPI Antibodies in Patients with Systemic Lupus Erythematosus

Ist Teil von

• PloS one, 2015-03, Vol.10 (3)

Ort / Verlag

Public Library of Science

Erscheinungsjahr

2015

Link zum Volltext

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Background Neuropsychiatric systemic lupus erythematosus (NPSLE) is a common and potentially fatal manifestation of SLE. Antiphospholipid antibodies (aPL) such as lupus anticoagulant (LA), anticardiolipin (aCL) and antibodies to [beta]2glycoprotein I (anti-[beta]2GPI), the most important aPL antigen, are thought to play a role in some forms of NPSLE. As of yet, their specific roles in NPSLE manifestations remain to be elucidated. Methodology/Principal Findings 57 SLE patients (53 women) were assessed for LA, aCL and anti-[beta].sub.2 GPI twice, to determine persistent positivity. All patients were examined by neurology and psychiatry specialists. 69 healthy subjects were assessed as controls. NPSLE was diagnosed in 74% of patients. Headaches were the most prevalent manifestation of NPSLE (39%), followed by cerebrovascular disease (CVD) (23%), depressive disorders (19.0%), and seizures (14%). NPSLE and non-NPSLE patients showed comparable SLE activity and corticosteroid use. In 65% of patients neuropsychiatric manifestations preceded SLE diagnosis. aPL profiles of NPSLE patients and non-NPSLE patients were similar. Headaches and ischemic stroke were independently associated with anti-[beta].sub.2 GPI-IgM (OR=5.6; p0.05), and seizures were linked to anti-[beta].sub.2 GPI-IgG (OR=11.3; p=0.01). Conclusions In SLE patients, neuropsychiatric manifestations occur frequently and early, often before the disease is diagnosed. Autoantibodies to [beta]2GPI are linked to non-specific headaches, ischemic stroke and seizures, and show a better predictive value than aCL and LA. These findings may help to improve the diagnosis of NPSLE and should prompt further studies to characterize the role of anti-[beta]2GPI in the pathogenesis of this condition.