Anti–β2-glycoprotein I antibodies in pediatric systemic lupus erythematosus and antiphospholipid syndrome
Article first published online: 12 AUG 2002
Copyright © 2002 by the American College of Rheumatology
Arthritis Care & Research
Volume 47, Issue 4, pages 414–420, 15 August 2002
How to Cite
von Scheven, E., Glidden, D. V. and Elder, M. E. (2002), Anti–β2-glycoprotein I antibodies in pediatric systemic lupus erythematosus and antiphospholipid syndrome. Arthritis & Rheumatism, 47: 414–420. doi: 10.1002/art.10510
- Issue published online: 12 AUG 2002
- Article first published online: 12 AUG 2002
- Manuscript Accepted: 8 DEC 2001
- Manuscript Received: 19 JUL 2001
- NIH. Grant Numbers: AR-20684, M01-RR01271
- Arthritis Foundation, Northern California Chapter
- Lupus anticoagulant;
To determine whether serum β2-glycoprotein I antibody (anti-β2GPI) detection improves identification of pediatric subjects at risk for antiphospholipid syndrome (APS).
Serum antiphospholipid antibodies (aPL) were identified by anticardiolipin enzyme-linked immunosorbent assay (ELISA), lupus anticoagulant assays, and syphilis screening in children with primary APS, systemic lupus erythematosus (SLE), or SLE plus APS. Anti-β2GPI level and isotype were determined by β2GPI ELISA and correlated with clinical manifestations and other aPL assays.
One hundred-ten subjects under 22 years of age and of mixed ethnicity were evaluated. Fifty-seven had SLE (including 14 with APS), 25 had primary APS, 16 had SLE-like APS, 6 were healthy children with aPL detected incidentally, 4 had other rheumatic diseases and 2 had other conditions. Anti-β2GPI were detected in 48% of SLE subjects and did not improve aPL detection over standard tests. Anti-β2GPI were associated with stroke (P = 0.014), but not with other APS manifestations, and were rarely detected in primary APS. Among subjects with APS manifesting as chronic thrombocytopenia, anti-β2GPI distinguished subjects with SLE from those with primary APS.
With the exception of stroke, anti-β2GPI detection does not improve identification of pediatric APS over that of traditional aPL assays. Anti-β2GPI are rare in pediatric primary APS, but may predict evolution of chronic thrombocytopenia to SLE.