Summary
A multicenter study was set up to evaluate the prevalence, clinical and biological
significance of antiphosphatidylethanolamine antibodies (aPE) in thrombotic patients
with or without the main known clinical and biological risk factors for thrombosis.
APE and antibodies, defined as the laboratory criteria of antiphospholipid syndrome
(APS) -lupus anticoagulant, anticardiolipin and anti-beta2-GPI antibodies were measured
in 270 patients with thrombosis (234 venous and 37 arterial) and 236 matched controls.
APE were found in 15% of thrombotic patients compared to 3% of controls (p<0.001)
with no predominant isotype, no association with the main known clinical or biological
risk factors for thrombosis neither with a type of thrombosis, arterial or venous.
In a multivariate logistic regression analysis of antibodies, aPE showed the highest
association with thrombosis (odds ratio [OR]: 4.2, p<0.001). Moreover, using a multivariate
analysis in a case-control subgroup study on 158 patients, IgGaPE were found to be
significantly associated with venous thrombosis (OR:6;p=0.005). Interestingly, 25
of the 40 aPE-positive patients (63%) were negative for the APS laboratory criteria.
Most of them (21/25) had venous thrombosis, recurrent in ten of them. Four patients
also suffered from early or late miscarriages. Our results underline the strength
of the association between the presence of aPE and thrombosis and suggest their measurement
in thrombotic patients, especially when lupus anticoagulant, anticardiolipin or anti-beta2-GPI
antibodies are absent.
Keywords
thrombosis - clinical studies - antiphospholipid syndrome - Antiphospholipid antibodies
- phosphatidylethanolamine