Ultrastructural skin changes and clinical picture in SLE with positive anticardiolipin anti-bodies

Abstract EN

Anticardiolipin antibodies (ACLA) are members of the group of antiphospholipids; they are immunoglobulins formed of IgG and IgM antibodies.

The aim of this work was to detect the presence of ACLA in systemic lupus erythematosus (SLE) patients and try to throw some light on it’s clinical significance.

Also ultrastructural skin biopsies from those patients were studied with the electron microscope.

Accordingly 28 subjects (18 SLE patients and 10 apparently healthy controls) were included in this study.

The results showed that arthritis, mucocutaneous manifestations and renal involvement were the commonest clinical manifestations in SLE patients (83.3 %, 66.6 % and 50 % respectively).

The percentage of the presence of IgG ACLA in this work was 22.2 % and IgM ACLA was 11.2 %.

There was a significant association between +ve IgG ACLA and some clinical manifestations including mucocutaneous ones, vasculitis, fetal loss and thrombosis (p < 0.001).

Ultrastructural study of skin biopsies with the electron microscope showed early thrombus formation only in SLE patients with positive IgG ACLA without any evidence of vasculitis.

From this study we concluded that, ACLA are associated significantly with some manifestations of ACLA syndrome such as mucocutaneous manifestations, vasculitis, fetal loss, and thrombosis, including thrombosis of dermal blood vessels as detected by electron microscopic study without evidence of vasculitis.