Acquired activated protein C resistance associated with anti-protein S antibody as a strong risk factor for DVT in non-SLE patients.

Abstract

Anti-phospholipid (aPL) antibodies (Abs) are well known to be associated with thromboembolic events in patients with systemic lupus erythematosus (SLE). However, the clinical relevance of a PL Abs in patients without SLE (non-SLE) who have venous thromboembolism remains unclear. We evaluated 143 non-SLE patients with a first episode of clinically suspected deep vein thrombosis (DVT) by using objective tests for diagnosing DVT and laboratory tests including the activated protein C resistance (APC-R) test, the factor V Leiden test, and various aPL Abs. The prevalence of acquired APC-R, in which case there was no factor V Leiden mutation, was significantly higher in patients with DVT (15/58 cases, 25.9%, p < 0.0001) than in those without DVT (3/80 cases, 3.7%), and confirmed that acquired APC-R was a strong risk factor for DVT (odds ratio [OR], 8.95; 95% confidence intervals [CI], 2.45-32.7; p < 0.001). Multivariate logistic analysis revealed that the presence of LA, aCL, anti-beta2-glycoprotein I, anti-prothrombin and anti-protein C Abs was not reliable as a risk factor for DVT in non-SLE patients, and that the presence of anti-protein S Abs was the most significant risk factor for DVT (OR, 5.88; 95% CI, 1.96-17.7; p < 0.002). Furthermore, the presence of anti-protein S Abs was strongly associated with acquired APC-R (OR, 57.8; 95% CI, 8.53-391; p < 0.0001). These results suggest that acquired APC-R may reflect functional interference by anti-protein S Abs of the protein C pathway, which action may represent an important mechanism for the development DVT in non-SLE patients.

• Authors: Junzo Nojima, Hirohiko Kuratsune, Etsuji Suehisa, Tomio Kawasaki, Takashi Machii, Teruo Kitani, Yoshinori Iwatani, Yuzuru Kanakura
• Journal: Thrombosis and haemostasis (Thromb Haemost) Vol. 88 Issue 5 Pg. 716-22 (Nov 2002) ISSN: 0340-6245 [Print] Germany
• PMID: 12428083 (Publication Type: Journal Article)

Chemical References

• Antibodies, Antiphospholipid
• Autoantibodies
• Glycoproteins
• Protein C
• Protein S
• beta 2-Glycoprotein I
• factor V Leiden
• Factor V
• Prothrombin

Topics

• Activated Protein C Resistance (complications, diagnosis)
• Adult
• Aged
• Aged, 80 and over
• Antibodies, Antiphospholipid (analysis)
• Autoantibodies (blood, physiology)
• Factor V (analysis)
• Female
• Glycoproteins (immunology)
• Humans
• Male
• Middle Aged
• Odds Ratio
• Protein C (immunology)
• Protein S (immunology)
• Prothrombin (immunology)
• Risk Factors
• Venous Thrombosis (etiology, genetics, immunology)
• beta 2-Glycoprotein I