Thromb Haemost 1994; 72(02): 209-213
DOI: 10.1055/s-0038-1648840
Original Article
Schattauer GmbH Stuttgart

Prevalence, Follow-Up and Clinical Significance of the Anticardiolipin Antibodies in Normal Subjects

P Vila
1   Servicios de Hematología Hospital Santa María Madre, Orense
,
M C Hernández
1   Servicios de Hematología Hospital Santa María Madre, Orense
,
M F López-Fernández
2   Hospital Juan Canalejo-Teresa Herrera, La Coruña, Spain
,
J Batlle
2   Hospital Juan Canalejo-Teresa Herrera, La Coruña, Spain
› Author Affiliations
Further Information

Publication History

Received 06 January 1994

Accepted after resubmission 06 April 1994

Publication Date:
24 July 2018 (online)

Summary

To date very few studies that analyze the prevalence of anticardiolipin antibodies (ACA) in healthy subjects have been reported. No data based on a systematic analysis of normal subjects with positive ACA is available. The aim of the present study was to evaluate the prevalance of ACA, its clinical significance and relationship to the lupus anticoagulant (LA) and other autoimmune parameters in an apparently healthy population. 552 normal blood donors from a blood bank were randomly selected. ACA positive donors who consented were monitored over a period of twelve months and tested every three months. ACA (IgG and IgM isotypes) were quantitated by enzyme linked immunoassay (ELISA). The prevalance for IgG ACA in our donor population was estimated to be 6.5%, and 9.4% for IgM ACA, which is similar to the one previously reported for IgG and slightly higher for IgM. It is worth noting that in our study ACA positive donors exhibited a progressive negativization. Eight donors with IgG ACA and seven with IgM ACA remained positive for nine months. Five donors with IgG ACA and four with IgM ACA had family history of thromboembolic disease. One donor with IgG ACA and two with IgM ACA had had unexplained miscarriages in the past. We did not find any relationship between ACA and LA, nor between ACA positivity and the clinical and laboratory data studied. Pseudopositivity for lues was not found. No thrombotic event occurred in donors that were positive for ACA during the 12-month follow-up.

 
  • References

  • 1 Hughes GR. The antiphospholipid syndrome: ten years on. Lancet 1993; 342: 341-344
  • 2 Eber B. The role of anticardiolipin antibodies in the pathogenesis of arterial and venous thrombosis. Acta Med Austriaca 1990; 17: 67-70
  • 3 Kapiotis S, Speiser W, Pabinger-Fasching I, Kyrle PA, Lechner K. Anticar-diolipin antibodies in patients with venous thrombosis. Haemostasis 1991; 21: 19-24
  • 4 Llobet D, Gari M, Tirado I, Marti S, Mateo J, Borrell M, Fontcuberta J. Estudio de anticuerpos antifosfolfpidos en 1544pacientes con trombosis correlacionados con otras variables (EBT 2). Sangre 1992; 37 (Suppl) (Suppl. 04) 57 (abstract)
  • 5 Creagh MD, Malia RG, Cooper SM, Smith AR, Duncan SL, Greaves M. Screening for lupus anticoagulant and anticardiolipin antibodies in women with fetal loss. J Clin Pathol 1991; 44: 45-47
  • 6 Parke AL, Wilson D, Maier D. The prevalance of antiphospholipid antibodies in women with recurrent spontaneous abortion, women with successful pregnancies, and women who have never been pregnant. Arthritis Rheum 1991; 34: 1231-1235
  • 7 Lechner K, Pabinger-Fasching I. Lupus anticoagulants and thrombosis: a study of 25 cases and review of literature. Haemostasis 1985; 15: 254-262
  • 8 Gastineau DA, Kazmier FJ, Nichols WL, Bowie EJW. Lupus anticoagulant: An analysis of the clinical and laboratory features of 219 cases. Am J Hematol 1985; 19: 265-275
  • 9 Elias M, Eldor A. Thromboembolism in patients with the lupus type anticoagulant. Arch Intern Med 1984; 144: 510-515
  • 10 Lubbe WF, Butler WS, Palmer SJ, Liggins GC. Lupus anticoagulant in pregnancy. Br J Obstet Gynaecol 1984; 91: 357-363
  • 11 Branch WD, Scott JR, Kochenour NK, Hershgold E. Obstetric complications associated with the lupus anticoagulant. N Engl J Med 1985; 313: 1322-1326
  • 12 Ishii Y, Nagasawa K, Mayumi T, Niho Y. Clinical importance of persistence of anticardiolipin antibodies in systemic lupus erythematosus. Ann Rheum Dis 1990; 49: 387-390
  • 13 Love PE, Santoro SA. Antiphospholipid antibodies: anticardiolipin and the lupus anticoagulant in systemic lupus erythematosus (SLE) and in non-SLE disorders. Prevalance and clinical significance. Ann Intern Med 1990; 112: 682-698
  • 14 Triplett DA. Laboratory diagnosis of lupus anticoagulants. Semin Thromb Haemost 1990; 16: 182-192
  • 15 Triplett DA, Brandt JT. Lupus anticoagulant: Misnomer, paradox, riddle epiphenomenon. Hematol Pathol 1988; 2: 121-143
  • 16 Harris EN, Gharavi AE, Hedge V, Derue G, Morgan SH, Englert H, Chan JKH, Asherson RA, Heghes GR. Anticardiolipin antibodies in autoimmune thrombocytopenic purpura. Br J Haematol 1985; 59: 231-234
  • 17 Harris EN, Asherson RA, Gharavi AE, Morgan SH, Derue G, Hughes GR. Thrombocytopenia in SLE and related autoimmune disorders: Association with anticardiolipin antibody. Br J Haematol 1985; 59: 227-230
  • 18 Hamsten A, Bjorkholm M, Norberg R, de Faire U, Holm G. Antibodies to cardiolipin in young survivors of myocardial infarction: an association with recurrent cardiovascular events. Lancet 1986; i: 113-5
  • 19 Coull BM, Bourdette DN, Goodnight SH, Briley DP, Hart R. Multiple cerebral infarctions and dementia associated with anticardiolopin antibodies. Stroke 1987; 18: 1107-1112
  • 20 Harris EN, Charavi AE, Asherson RA, Boey ML, Hughes GR. Cerebral in-farctation in systemic lupus: association with anticardiolipin antibodies. Clin Exp Rheumatol 1984; 2: 47-51
  • 21 Vermylen J, Blockmans D, Spitz B, Deckmyn H. Thrombosis and immune disorders. Clin Haematol 1986; 15: 393-409
  • 22 Font J, Cervera R, López Soto A, Pallares L, Bosch X, Ampurdanes S, Casals FJ, Ingelmo M. Anticardiolipin antibodies in patients with autoimmune diseases isotype distribution and clinical associations. Clin Rheumatol 1989; 8: 457-483
  • 23 Keane A, Woods R, Dowding V, Roden D, Barry C. Anticardiolipin antibodies in rheumatoid arthritis. Br J Rheumatol 1987; 26: 346-350
  • 24 Alarcón-Segovia D, Sánchez GuerreroJ. Primary antiphospholipid syndrome. J Rheumatol 1989; 16: 482-488
  • 25 Asherson RA, Khamashta MA, Ordi-Ros J, Derksen RH, Machin SJ, Path FR, Barquinero J, Outt HH, Harris EN, Phil DM, Vilardell-Torres M, Hughes GR. The primary antiphospholipid syndrome: major clinical and serological features. Medicine 1989; 68: 366-374
  • 26 Hughes GR. The anticardiolipin syndrome. Clin Exp Rheumatol 1985; 3: 285-286
  • 27 Harris EN. Syndrome of the black swan. Br J Rheumatol 1987; 26: 324-326
  • 28 Harris EN, Gharavi AE, Boey ML, Patel BM, Mackworth-Young CG, Loi-zou S, Hughes GR. Anticardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. Lancet 1983; ii: 1211-1214
  • 29 Branch DW, Rote NS, Dostal DA, Scott JR. Association of lupus anticoagulant with antibody against phosphatidilserine. Clin Immunol Immuno-pathol 1987; 42: 63-75
  • 30 Ginsburg KS, Liang MH, Newcomer L, Goldhaber SZ, Schur PH, Henne-kens CH, Stampfer MJ. Anticardiolipin antibodies and the risk for ischemic stroke and venous thrombosis. Ann Inter Med 1992; 117: 997-1002
  • 31 Barbui T, Cortelazzo S, Galli M, Parazzini F, Radici E, Rossi E, Finazzi G. Antiphospholipid antibodies in early repeated abortions: a case-controlled study. Fertil Steril 1988; 50: 589-592
  • 32 Durán-Suárez JR. Incidence of circulating anticoagulants in a normal population. Acta Haematol (Basel) 1982; 67: 217-219
  • 33 Harris EN, Spinnato JA. Should anticardiolipin tests be performed in otherwise healthy pregnant women?. Am J Obstet Gynecol 1991; 165: 1272-1277
  • 34 Shi W, Krilis SA, Chong BH, Gordon S, Chesterman CN. Prevalence of lupus anticoagulant and anticardiolipin antibodies in a healthy population. AustNZJMed 1990; 20: 231-236
  • 35 Exner T. Comparison of two simple tests for the lupus anticoagulant. Am J Clin Pathol 1985; 83: 215-218
  • 36 Harris EN, Phil M. The second international anticardiolipin standardization workshop. The Kingston anti-phospholipid antibody study (KAPS) group. Am J Clin Pathol 1990; 94: 476-484
  • 37 Thiagarajan P, Shapiro SS. Lupus anticoagulants. In: Disorders of thrombin formation Colman RW. ed Churchill Livingstone; London: 1983. pp 101-108
  • 38 Triplett DA, Brandt JT, Kaczor D, Scaeffer J. Laboratory diagnosis of lupus inhibitors: a comparison of the tissue thromboplastin inhibition procedure with a new platelet neutralization procedure. Am J Clin Pathol 1983; 79: 670-682
  • 39 Morton KE, Gavaghan TP, Krilis SA, Daggard GE, Baron DW, Hickie JB, Chesterman CN. Coronary artery bypass graft failure - an autoimmune phenomenon?. Lancet 1986; ii: 1353-1357
  • 40 Galve E, Ordi J, Barquinero J, Evangelista A, Vilardell M, Soler J. Valvular heart disease in the primary antiphospholipid syndrome. Ann Inter Med 1992; 116: 293-298
  • 41 Harris EN, Gharavi AE, Patel SP, Hughes GR. Evaluation of the anticar-diolipin antibody test: report of an international workshop held 4 April 1986. Clin Exp Immunol 1987; 68: 215-222
  • 42 Exner T, Triplett DA, Taberne DA, Howard MA, Harris EN. Comparison of test methods for the lupus anticoagulant: International survey on lupus anticoagulant-1 (Isla-1). Thromb Haemost 1990; 64: 478-484
  • 43 Harris EN, Gharavi AE, Hughes GR. Antiphospholipid antibodies. Clin Rheum Dis 1985; 11: 591-609
  • 44 Hughes GR, Harris EN, Gharavi AE. Antiphospholipid antibodies. In: Immunology of rheumatic diseases Gupta S, Talal N. eds lenum Press; New York: 1985. pp 251-269
  • 46 Barquinero J, Ordi J. Anticuerpos antifosfolipidos. Med Clin 1987; 88: 455-458
  • 1 Ginsberg JS, Demers C, Brill-Edwards P, Johnston M, Bona R, Burrows RF, Weitz J, Denburg JA. Increased thrombin generation and activity in patients with systemic lupus erythematosus and anticardiolipin antibodies: Evidence for a prothrombotic state. Blood 1993; 81: 2958-2963
  • 47 Mannucci PM, Tripodi A, Bottasso B, Baudo F, Finazzi G, De Stefano V, Palareti G, Manotti C, Mazzuconi MG, Castaman G. Markers of procoagulant imbalance in patients with inherited thrombophilic syndromes. Thromb Haemost 1992; 67: 200-202
  • 48 Algiman M, Dietrich G, Nydegger UE, Boieldieu D, Sultan Y, Kazatchkine MD. Natural antibodies to factor VIII (anti-hemophilic factor) in healthy individuals. Proc Natl Acad Sci USA 1992; 89: 3795-3799
  • 49 Batlle J, Rodríguez RE, Castiñeira P, Lourés E, Vila P, Sedano C, Tusell X, Magallón M, Quintana M, Gonzalez Boullosa R, López Fernández MF. Non-inhibitor antibodies to factor VIII in hemophilia A patients and normal subjects. Thromb Haemost 1993; 69: 557 (abstract)