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Objective: To identify the osteoprotegerin (OPG) correlates with antiphospholipid syndrome (APS) parameters., Methods: Our cohort included 40 patients with primary APS disease associated with systemic lupus erythematosus (SLE) (mean age, 43.7 years; 87% female). Data on cardiovascular risk factors and specific clinical events in APS were collected. Then we tested OPG and 10 criteria and noncriteria antiphospholipid antibodies (aPLs) on preserved specimens in all cases., Results: A total of 26 patients (65%) had high serum OPG levels. Patients with high OPG were mostly overweight. In patients with SLE, the OPG levels were associated with anti-double-stranded DNA (anti-dsDNA) and anti-Sm titers. However, we did not find significant correlations of the OPG with any of the 10 aPLs tested. Also, we found no relationship regarding venous APS events., Conclusion: In APS, high OPG levels are not linked to serum aPL expression., (© American Society for Clinical Pathology 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: The patients with antiphospholipid syndrome (APS) associate an increased risk of atherosclerosis., Objective: To determine the predictors of an abnormal ankle-brachial index (ABI), surrogate measure of atherosclerosis, in patients with APS., Methods: The ABI was measured according to standard recommendations in 106 patients. Traditional cardiovascular risk factors were assessed in all cases. A large spectrum of APS antibodies was determined in 73 patients., Results: A total of 106 patients diagnosed with APS were included. 28.3% patients included were found to have low ABI. Anti-beta 2-glycoprotein I (aβ2GPI) IgG antibodies [4.00 (1.00-79.00) vs 3.00 (0.00-29.00) U/mL, P = 0.02] and antiprothrombin (aPT) IgM antibodies [4.50 (0.00-82.00) vs 3.00 (0.00-14.00) U/mL, P = 0.05] titers were found to be higher in patients with abnormal ABI. However, after multivariate regression analysis, only the aβ2GPI IgG titer remained predictor of low ABI (P = 0.04)., Conclusions: aβ2GPI IgG associated with impaired ABI in patients with APS. This relation might reflect their involvement in the atherosclerosis occurrence., (© 2018 Wiley Periodicals, Inc.)

The place of non-criteria antiphospholipid antibodies (aPLs) in the diagnosis of antiphospholipid syndrome (APS) is still debatable. The aim of this research was to evaluate the correlations between the titres of non-criteria aPLs (anti-phosphatidylethanolamine (aPE), anti-phosphatidylserine (aPS), and anti-prothrombin (aPT) antibodies), and the ones of the already studied criteria aPLs (anti-cardiolipin (aCL) and anti-β2 glycoprotein I-aβ2GPI antibodies). Altogether, 72 APS (30 primary and 42 secondary) patients were included in our study. High correlation coefficients (rs) were found between aPS IgM and aCL IgM, overall (0.77, p < 0.01), as well as in the primary (0.81, p < 0.01), and secondary (0.75, p < 0.01) APS subgroups. Low or statistically insignificant correlations were observed between IgG/IgM isotypes of aPT and aCL, or aβ2GPI, in the entire study population, and when evaluating the subgroups. Therefore, moderate correlations were mainly identified between the tested non-criteria antibodies and the criteria ones, suggesting little added value for the use of the tested non-criteria aPLs, with the exception of aPT, which seems to have different kinetics and might be a promising APS diagnostic tool. [ABSTRACT FROM AUTHOR]

Introduction: Systemic lupus erythematosus (SLE) is a complex autoimmune pathology that can involve any organ. Lupus-related acute pancreatitis (AP) is, together with lupus mesenteric vasculitis, an important cause of SLE-induced acute abdominal pain. Methods: A literature search was conducted using the terms "Pancreatitis" and "Lupus Erythematosus, Systemic" on PubMed/Medline and Web of Science from January 2007 to January 2020. Clinical characteristics, diagnostic approach, and treatment principles in SLE-related AP are presented in this review. Results: Mainly retrospective reports were identified. The reported incidence of SLE-associated AP ranges from 0.9 to more than 5% of patients. A total of 264 SLE patients were found in the selected research, with a net female predominance (sex ratio 9:1) and mean age of 31.4 years. Abdominal pain was virtually present in all cases. AP occurrence was more frequent in SLE patients with short disease duration, high activity scores, and multiorgan involvement. The AP definition was based on currently available guidelines and after exclusion of any other known causes (including iatrogenic, i.e. drugs), a diagnosis of "idiopathic" SLE-related AP might be sustained. Management is difficult, as there is no standardized therapeutic approach. Of note, glucocorticoid use remains still controversial as, especially for high doses, subsequent pancreatic injury may occur. Monitoring serum lipase levels after high dose steroids might be considered. One study reported beneficial prognostic effect of plasma exchange. Moreover, AP in SLE might raise awareness about macrophage activation syndrome association. Mortality up to one third of AP cases in SLE was reported. Conclusion: The SLE-related AP is a rare, but severe, life-threatening complication. Corticosteroids must be used with caution. Plasma exchange could be considered in selected cases. [ABSTRACT FROM AUTHOR]

Introduction. Patients with antiphospholipid syndrome (APS) may have a large spectrum of thrombotic clinical events (arterial or venous), but the factors that determine the occurrence of specifi c clinical manifestation has not been clearly established. Objective. The aim of the study was to determine the factors associated with a history of deep vein thrombosis (DVT) in patients with APS. We were especially interested to fi nd an association between the criteria and noncriteria antiphospholipid antibodies (APLAs) and the DVT. Methods. We realized a cross-sectional study, with consecutive enrollment of all patients presented in our department with the diagnosis of APS in the period 2008-2011. From the total of 106 patients for which the demographic, clinical and biological parameters were collected, the assessment of the criteria and non-criteria APLAs was performed in 73 patients. Results. The mean age at inclusion was 44.7 years, the female-to-male ratio 6.6, and the mean APS disease duration 6.7 years. The majority of the patients included presented with secondary APS (70 patients). Lupus anticoagulant was the most frequent immunological marker used to sustain the diagnosis of APS, found positive in 102 patients (96.2%). The recurrent DVT was more frequently observed in patients with primary APS than in those with secondary APS (p = 0.02). No signifi cant association with DVT was found for the clinical parameters traditionally associated with the risk of thrombosis that we have taken into study: smoking, body mass index (BMI), waist circumference and waist-to-hip ratio. We found a positive association between the DVT history and the positivity for the IgM anti-β2 glycoprotein I antibodies [OR (95%CI) = 6.95 (1.36-35.58), p = 0.01]. The titer of IgG antiprothrombin antibodies and IgG antiphosphatidylethanolamine antibodies was higher in patients with previous DVT [3.0 (0.0-151.0) versus 2.0 (0.0-2.0), p = 0.01, respectively 5.0 (1.0-33.0) versus 3.0 (1.0-7.0), p = 0.01]. In the subgroup of patients with secondary APS, the previous DVT was associated only with the positivity for IgM anti-β2 glycoprotein I antibodies [OR (95%) = 13.63 (1.46-127.15), p = 0.02]. In the same subgroup, the levels of IgG anticardiolipin and the IgG antiphosphatidylethanolamine antibodies were higher in patients with previous DVT [2.0 (0.0-64.0) versus 1.0 (0.0-20.0), p = 0.02, respectively 3.0 (0.0-151.0) versus 2.0 (0.0-7.0), p = 0.03]. In patients with primary APS, the titer of IgG antiprothrombin antibodies was signifi cantly higher when DVT history were present [5.0 (1.0-3.0) versus 3.0 (1.0-7.0), p = 0.01. Only the titer of IgG antiprothrombin antibodies was associated with the history of recurrent thrombosis [5.0 (1.0-3.0) versus 3.0 (1.0-7.0), p = 0.01]. Conclusions. In patients with APS, the DVT history was related with the prevalence of the anti-β2 glycoprotein I antibodies, but also with the levels of some non-criteria antibodies, IgG antiprothrombin antibodies and IgG antiphosphatidylethanolamine antibodies. In patients with primary APS, previous DVT is associated only with the titer of IgG antiprothrombin antibodies, whereas in patients with secondary APS, the DVT history were related with the presence of anti-β2 glycoprotein I antibodies and with the titers of both criteria antibodies (IgG anticardiolipin antibodies) and non-criteria antibodies (IgG antiphosphatidylethanolamine antibodies). The risk of recurrent thrombosis was higher in patients with primary APS when compared with those with secondary APS. Only the titers of IgG antiprothrombin antibodies were correlated with recurrent thrombosis. [ABSTRACT FROM AUTHOR]