Antiphospholipid antibodies and anticoagulant therapy: capillaroscopic findings.
Anticoagulant therapy
Antiphospholipid syndrome
Connective tissue diseases
Nailfold capillaroscopy
Systemic lupus erythematosus
Systemic sclerosis
Journal
Arthritis research & therapy
ISSN: 1478-6362
Titre abrégé: Arthritis Res Ther
Pays: England
ID NLM: 101154438
Informations de publication
Date de publication:
27 06 2021
27 06 2021
Historique:
received:
22
02
2021
accepted:
31
05
2021
entrez:
28
6
2021
pubmed:
29
6
2021
medline:
14
8
2021
Statut:
epublish
Résumé
Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by specific vascular and obstetric manifestations and by antiphospholipid antibodies (aPL) positivity. Microvascular damage in the course of APS and "aPL carrier" patients without symptoms is poorly investigated. This study aims to compare nailfold videocapillaroscopy (NVC) microvascular parameters in APS patients and non-symptomatic "aPL carriers" and to investigate their possible correlations with different aPL subtypes. NVC was performed during standard evaluations in 18 APS patients (mean age 50 ± 13.8 years), 24 "aPL carriers" without symptoms (mean age 46.4 ± 16.4 years), and 18 control patients (CTR) (mean age 74 ± 12.5 years) taking oral anticoagulants for non-immunological indications (i.e., cardiovascular accidents). All patients were investigated for the presence of dilated capillaries, giant capillaries, microhemorrhages, capillary loss, and further non-specific/specific abnormalities (i.e., branched "bushy" capillaries, sign of neoangiogenesis) by NVC. Every alteration was also classified according to a semi-quantitative score. Lupus anticoagulant, anticardiolipin antibodies, and antibeta2 glycoprotein I antibodies were tested in each patient. APS patients showed at NVC increased frequency of microhemorrhages (p = 0.039)-particularly a "comb-like" pattern (parallel hemorrhages) (p = 0.002)-than "aPL carriers". Of note, there were no significant differences concerning the isolated number of microhemorrhages between APS and the CTR group (p = 0.314), but "comb-like" hemorrhages were significantly more frequent in the APS group (p = 0.034). Not any significant correlation was found between the aPL subtypes and NVC parameters. APS patients showed significantly a greater number of non-specific NVC abnormalities than "aPL carriers", particularly the "comb-like" NVC pattern. Oral anticoagulants may represent a confounding factor for isolated microhemorrhages. Not any correlation was found between aPL subtypes and NVC parameters. Further investigations are needed to better characterize the microvascular endothelium damage induced by aPL.
Sections du résumé
BACKGROUND
Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by specific vascular and obstetric manifestations and by antiphospholipid antibodies (aPL) positivity. Microvascular damage in the course of APS and "aPL carrier" patients without symptoms is poorly investigated.
OBJECTIVES
This study aims to compare nailfold videocapillaroscopy (NVC) microvascular parameters in APS patients and non-symptomatic "aPL carriers" and to investigate their possible correlations with different aPL subtypes.
METHODS
NVC was performed during standard evaluations in 18 APS patients (mean age 50 ± 13.8 years), 24 "aPL carriers" without symptoms (mean age 46.4 ± 16.4 years), and 18 control patients (CTR) (mean age 74 ± 12.5 years) taking oral anticoagulants for non-immunological indications (i.e., cardiovascular accidents). All patients were investigated for the presence of dilated capillaries, giant capillaries, microhemorrhages, capillary loss, and further non-specific/specific abnormalities (i.e., branched "bushy" capillaries, sign of neoangiogenesis) by NVC. Every alteration was also classified according to a semi-quantitative score. Lupus anticoagulant, anticardiolipin antibodies, and antibeta2 glycoprotein I antibodies were tested in each patient.
RESULTS
APS patients showed at NVC increased frequency of microhemorrhages (p = 0.039)-particularly a "comb-like" pattern (parallel hemorrhages) (p = 0.002)-than "aPL carriers". Of note, there were no significant differences concerning the isolated number of microhemorrhages between APS and the CTR group (p = 0.314), but "comb-like" hemorrhages were significantly more frequent in the APS group (p = 0.034). Not any significant correlation was found between the aPL subtypes and NVC parameters.
CONCLUSIONS
APS patients showed significantly a greater number of non-specific NVC abnormalities than "aPL carriers", particularly the "comb-like" NVC pattern. Oral anticoagulants may represent a confounding factor for isolated microhemorrhages. Not any correlation was found between aPL subtypes and NVC parameters. Further investigations are needed to better characterize the microvascular endothelium damage induced by aPL.
Identifiants
pubmed: 34176504
doi: 10.1186/s13075-021-02551-6
pii: 10.1186/s13075-021-02551-6
pmc: PMC8237465
doi:
Substances chimiques
Antibodies, Antiphospholipid
0
Anticoagulants
0
Lupus Coagulation Inhibitor
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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