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Poster Presentations
P14 High frequency of ITP related auto-antibodies in patients with active SLE
  1. Anders Bengtsson1,
  2. John W Semple2,3,
  3. Leendert Porcelijn4,
  4. Rick Kapur5 and
  5. Petrus Linge1
  1. 1Section of Rheumatology, Dept. of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Skåne, Sweden
  2. 2Division of Hematology and Transfusion Medicine, Lund University, Lund, Sweden
  3. 3Clinical Immunology and Transfusion Medicine, Office of Medical Services, Region Skåne, Lund, Sweden
  4. 4Dept. of Immunohematology Diagnostics, Sanquin Diagnostic Services, Amsterdam, The Netherlands
  5. 5Sanquin Research, Dept. of Experimental Immunohematology and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

Abstract

Objective Systemic Lupus Erythematosus (SLE) is characterized by arthritis, rash, glomerulonephritis, and hematologic manifestations, including secondary immune mediated thrombocytopenia (ITP). Presence of ITP type, platelet specific glycoprotein antibodies have been detected in SLE, but their exact role and frequency is not known although thrombocytopenia can be of prognostic importance. The objective of this study was to determine the frequency of platelet specific antibodies in patients with SLE and if the presence of these antibodies is associated with disease activity.

Methods We collected serum samples from 74 patients with SLE (≥ 4 American College of Rheumatology 1982 criteria) during high (H) and lower (L) SLE Disease activity index 2000 (SLEDAI-2K) score (median SLEDAI-2K, H = 8.5 and L = 0.5). Mean age at the first sampling was 43,6 and the second 48,6 years. Antibodies towards platelet glycoproteins (GP) IIb/IIIa, GP V and GP Ib/IX were detected in H and L serum samples, using the direct monoclonal antibody immobilization of platelet antigens assay (MAIPA). We also analyzed the presence of antiphospholipid criteria and non-criteria antibodies: Anti-CL (IgG and IgM) Anti-B2GP1 (IgG and IgM) Anti-PS/PT (IgG and IgM) Anti-AnnexinV (IgG and IgM), using ELISA.

Results During H and L SLEDAI-2K we detected anti-GP IIb/IIIa antibodies in 29.7% vs 28.4%; anti-GP V antibodies in 48.6% vs 27.0% and anti-GP Ib/X antibodies in 58.1% vs 31.1%. The anti-GP V and anti-GP Ib/X levels were significantly higher in SLEDAI-2K H vs L and positively correlated with SLEDAI-2K score (r=0,322, p<0,0001 and r=0,265, p=0,001) using spearman correlation. During active disease, 66% had at least one positive GP-antibody, compared to 44% in the less active disease. All antiphospholipid antibodies of IgG type had significantly higher levels during SLEDAI-2K H. In total, 45% of patients had at least one positive antiphospholipid antibody during SLEDAI-2K H and 26% during L.

Conclusion This study shows that platelet autoantibodies are prevalent in SLE and their increased presence may be modulated by treatment and/or mechanisms regulating disease activity. Future studies will assess the functional contribution from these antibodies on platelet activation, thrombocytopenia and other aspects of SLE pathophysiology.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

https://doi.org/10.1136/lupus-2024-el.68

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