OBJECTIVE: To study clinical and laboratory features of primary antiphospholipid syndrome (PAPS) and that of secondary (SAPS) to systemic lupus erythematosus (SLE). METHODS: Twenty-seven PAPS and 32 SAPS patients were investigated in relation to the presence of arterial/venous thrombosis, fetal loss, reticular livedo, Raynaud phenomenon, autoimmune hemolytic anemia, thrombocytopenia, lymphopenia, anticardiolipin antibodies, lupus anticoagulant, antinuclear antibodies, anti-Sm and VDRL. Autoantibodies were investigated by ELISA (anticardiolipin and anti-Sm), indirect immunofluorescency (antinuclear antibodies) and by dilute prothrombin test, coagulation Kaolin test and dilute Russell viper venom test (lupus anticoagulant). RESULTS: Arterial thrombosis frequency was increased in PAPS (59.3% vs 25.0%, p=0.009) and venous thrombosis in SAPS (53.1% vs 33.3%; p>0.05), while there was no differences between frequencies of fetal loss (50.0% vs 56.7%), Raynaud phenomenon (18.5% vs 18.8%), reticular livedo (18.5% vs 12.5%), lupus anticoagulant (33.3% vs 37.5%), IgG anticardiolipin antibodies (79.2% vs 72,4%) and IgM anticardiolipin antibodies (58.4% vs 65.5%) in the two groups evaluated. Moreover, an increased frequency of lymphopenia (71.2% vs 7.4%; p<0.0001), antinuclear antibodies (100% vs 7.4%; p<0.0001) and positive VDRL (47.1% vs 5.0%, p=0.005) was observed in SAPS. CONCLUSIONS: Clinical and laboratory features were similar on PAPS and SAPS, although arterial thrombosis was associated to PAPS, and lymphopenia, antinuclear antibodies and VDRL were associated to SAPS.
antiphospholipid syndrome; systemic lupus erythe matosus; thrombosis; anticardiolipin antibodies; lupus anticoagulant
