Predictive value of persistent versus transient antiphospholipid antibody subtypes for the risk of thrombotic events in pediatric patients with systemic lupus erythematosus
Abstract
Study objectives were to determine, in children with systemic lupus erythematosus (SLE), (1) the association of antiphosholipid antibody (APLA) subtypes with thrombotic events (TEs) and (2) the predictive value of persistent versus transient antibodies for TEs. This is a cohort study of 58 SLE children in whom lupus anticoagulants (LAs), anticardiolipin antibodies (ACLAs), anti-beta2-glycoprotein-I (anti-beta2-GPI), and antiprothrombin (anti-PT) were assessed on at least 2 occasions (more than 3 months apart). Antibodies were classified as persistent (positive on at least 2 occasions) or transient (positive once). Outcomes were symptomatic TEs confirmed by objective radiographic tests identified retrospectively and prospectively. Seven of the 58 patients (12%) had 10 TEs; 5 patients had TEs during prospective follow-up. Persistent LAs showed the strongest association with TEs (P < .001). Persistent ACLAs (P = .003) and anti-beta2-GPI (P = .002) were significantly associated with TEs; anti-PT (P = .063) showed a trend. Persistent or transient LAs and anti-beta2-GPI showed similar strength of association, while ACLAs and anti-PT were no longer associated with TEs. Positivity for multiple APLA subtypes showed stronger associations with TEs than for individual APLA subtypes because of improved specificity. Lupus anticoagulant is the strongest predictor of the risk of TEs; other APLA subtypes provide no additional diagnostic value. Anticardiolipin antibodies and anti-PT require serial testing because only persistent antibodies are associated with TEs.
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For transiently positive antibodies, the strength of the association with thrombosis decreased for aCL and aPT, but remained the same for LA and anti-β2-glycoprotein I.
“For transiently positive antibodies, the strength of the association with thrombosis decreased for aCL and aPT, but remained the same for LA and anti-β2-glycoprotein I.”
From Antiphospholipid patterns predict risk of thrombosis in systemic lupus erythematosus (2021) · cites this paper as [45]
Male et al. found, in multivariate analyses, that LA was the strongest predictor of thrombosis, even if grouping patients with one or two positive tests.
“Male et al. [45] found, in multivariate analyses, that LA was the strongest predictor of thrombosis, even if grouping patients with one or two positive tests.”
From Antiphospholipid patterns predict risk of thrombosis in systemic lupus erythematosus (2021) · cites this paper as [45]
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- Authors
- Male, C., Foulon, D., Hoogendoorn, H., Vegh, P., Silverman, E., David, M., & Mitchell, L.
- Affiliations
- Hospital for Sick Children (CA)
- From the Children's Hospital, Medical University of Vienna, Austria; Henderson Research Centre, McMaster University, Hamilton, ON; Hospital for Sick Children, Toronto, ON; Hôpital Ste Justine, Montreal, QC; and Stollery Children's Hospital, Edmonton, AB, Canada.
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2005-12-15
- Volume
- 106
- Issue
- 13
- Pages
- 4152-4158
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- OpenAlex
- W1963752281
- Cited by
- 106
- References
- 49
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 6 · 2020: 5 · 2019: 4 · 2017: 4 · 2016: 9 · 2015: 3 · 2014: 5 · 2013: 3 · 2012: 10
- FWCI
- 4.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Blood (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Keywords
- systemic lupus erythematosus, pediatric lupus, antiphospholipid antibodies, thrombotic complications, lupus anticoagulant, anticardiolipin antibodies, anti-beta2-glycoprotein I antibodies, anti-prothrombin antibodies, thrombosis risk prediction
- MeSH terms
- Adolescent, Adult, Child, Child, Preschool, Female, Humans, Lupus Erythematosus, Systemic, Male, Predictive Value of Tests, Prospective Studies, Retrospective Studies, Risk Factors, Thrombosis, Time Factors, Cohort Studies, Antibodies, Antiphospholipid
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