Antinucleosome antibodies may help predict development of systemic lupus erythematosus in patients with primary antiphospholipid syndrome

Abstract

Patients with primary antiphospholipid syndrome (PAPS) may evolve to systemic lupus erythematosus (SLE), even many years later. This makes differentiation between primary and secondary antiphospholipidsyndrome a difficult task. Studies in murine models of lupus have shown that the developmentof antinucleosome(anti-NCS) antibodiesmay occur from the early stages of life. We therefore hypothesizethat anti-NCS antibodies could help predict developmentof SLE in patients with PAPS. We studied anti-NCS antibodies in 18 PAPS patients (15 female, three male), followed for a mean of 11 years to evaluate the potential development of SLE. When PAPS was diagnosed, nine patients were positive for anti-NCS antibodies. Six of them developed clinical manifestationsof SLE. In contrast, none of the patients who were negative to anti-NCS antibodies developed it. These findings suggest that anti-NCS antibodiescould help predict which patients with PAPS may eventually develop SLE.

Keywords

antinucleosome antibodies primary antiphospholipid syndrome systemic lupus erythematosus

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