Platelet-bound C4d, low C3 and lupus anticoagulant associate with thrombosis in SLE
Background Low C3 and lupus anticoagulant (LAC) are known risk factors for thrombosis in SLE. We evaluated the association between C4d products deposited on platelets (PC4d) and thrombosis in SLE. Antiphosphatidyl serine/prothrombin (PS/PT) complex antibody was also evaluated as an alternative to LA...
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BMJ Publishing Group
2019-12-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/6/1/e000318.full |
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| author | John Conklin Thierry Dervieux Tyler O'Malley |
| author_facet | John Conklin Thierry Dervieux Tyler O'Malley |
| author_sort | John Conklin |
| collection | DOAJ |
| description | Background Low C3 and lupus anticoagulant (LAC) are known risk factors for thrombosis in SLE. We evaluated the association between C4d products deposited on platelets (PC4d) and thrombosis in SLE. Antiphosphatidyl serine/prothrombin (PS/PT) complex antibody was also evaluated as an alternative to LAC.Methods This was a cross-sectional analysis of 149 consented patients with SLE (mean age: 47±1 years, 86% female) classified with (n=16) or without (n=133) thrombotic events in the past 5 years. Abnormal PC4d (≥20 units) was measured using flow cytometry. LAC and C3 were measured using dilute Russell’s viper venom time (>37 s) and immunoturbidimetry, respectively. Anti-PS/PT antibody status (IgG) was measured by immunoassay. Statistical analysis consisted of logistic regression and calculation of OR estimates with 95% CI.Results Abnormal PC4d (OR=8.4, 95% CI 2.8 to 24.8), low C3 (OR=9.5, 95% CI 3.0 to 30.3), LAC (OR=5.4, 95% CI 1.3 to 22.3) and anti-PS/PT IgG (OR=3.4, 95% CI 1.2 to 9.7) status associated with thrombosis (p<0.05). Cumulatively, the presence of PC4d, low C3 and LAC abnormalities as a composite risk score was higher in the presence of thrombosis (1.93±0.25) than in its absence (0.81±0.06) (p<0.01). Each unit of this composite risk score yielded an OR of 5.2 (95% CI 2.5 to 10.7) to have thrombosis (p<0.01). The composite risk score with anti-PS/PT antibody status instead of LAC also associated with thrombosis (p<0.01).Conclusion A composite risk score including PC4d, low C3 and LAC was associated with recent thrombosis and acknowledges the multifactorial nature of thrombosis in SLE. |
| format | Article |
| id | doaj-art-2de6cf903eb6412d9a28ec283edf07e3 |
| institution | DOAJ |
| issn | 2053-8790 |
| language | English |
| publishDate | 2019-12-01 |
| publisher | BMJ Publishing Group |
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| series | Lupus Science and Medicine |
| spelling | doaj-art-2de6cf903eb6412d9a28ec283edf07e32025-08-20T02:49:05ZengBMJ Publishing GroupLupus Science and Medicine2053-87902019-12-016110.1136/lupus-2019-000318Platelet-bound C4d, low C3 and lupus anticoagulant associate with thrombosis in SLEJohn Conklin0Thierry Dervieux1Tyler O'Malley21Exagen, Vista, United States of America1Exagen, Vista, United States of AmericaExagen, Vista, California, USABackground Low C3 and lupus anticoagulant (LAC) are known risk factors for thrombosis in SLE. We evaluated the association between C4d products deposited on platelets (PC4d) and thrombosis in SLE. Antiphosphatidyl serine/prothrombin (PS/PT) complex antibody was also evaluated as an alternative to LAC.Methods This was a cross-sectional analysis of 149 consented patients with SLE (mean age: 47±1 years, 86% female) classified with (n=16) or without (n=133) thrombotic events in the past 5 years. Abnormal PC4d (≥20 units) was measured using flow cytometry. LAC and C3 were measured using dilute Russell’s viper venom time (>37 s) and immunoturbidimetry, respectively. Anti-PS/PT antibody status (IgG) was measured by immunoassay. Statistical analysis consisted of logistic regression and calculation of OR estimates with 95% CI.Results Abnormal PC4d (OR=8.4, 95% CI 2.8 to 24.8), low C3 (OR=9.5, 95% CI 3.0 to 30.3), LAC (OR=5.4, 95% CI 1.3 to 22.3) and anti-PS/PT IgG (OR=3.4, 95% CI 1.2 to 9.7) status associated with thrombosis (p<0.05). Cumulatively, the presence of PC4d, low C3 and LAC abnormalities as a composite risk score was higher in the presence of thrombosis (1.93±0.25) than in its absence (0.81±0.06) (p<0.01). Each unit of this composite risk score yielded an OR of 5.2 (95% CI 2.5 to 10.7) to have thrombosis (p<0.01). The composite risk score with anti-PS/PT antibody status instead of LAC also associated with thrombosis (p<0.01).Conclusion A composite risk score including PC4d, low C3 and LAC was associated with recent thrombosis and acknowledges the multifactorial nature of thrombosis in SLE.https://lupus.bmj.com/content/6/1/e000318.full |
| spellingShingle | John Conklin Thierry Dervieux Tyler O'Malley Platelet-bound C4d, low C3 and lupus anticoagulant associate with thrombosis in SLE Lupus Science and Medicine |
| title | Platelet-bound C4d, low C3 and lupus anticoagulant associate with thrombosis in SLE |
| title_full | Platelet-bound C4d, low C3 and lupus anticoagulant associate with thrombosis in SLE |
| title_fullStr | Platelet-bound C4d, low C3 and lupus anticoagulant associate with thrombosis in SLE |
| title_full_unstemmed | Platelet-bound C4d, low C3 and lupus anticoagulant associate with thrombosis in SLE |
| title_short | Platelet-bound C4d, low C3 and lupus anticoagulant associate with thrombosis in SLE |
| title_sort | platelet bound c4d low c3 and lupus anticoagulant associate with thrombosis in sle |
| url | https://lupus.bmj.com/content/6/1/e000318.full |
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