Rheumatology Medical News about anti-phospholipid antibodies;immunohistochemical detection;intravascular platelet microthrombi;lupus nephritis

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Immunohistochemical detection of intravascular platelet microthrombi in patients with lupus nephritis and anti-phospholipid antibodies
Rheumatology, 06/24/09

Galindo M et al. - Study demonstrates that immunodetection of intravascular CD61+ platelet aggregates is more sensitive than histological evaluation to detect acute microthrombosis and provides a better correlation with anti-phospholipid syndrome (aPLs) in systemic lupus erythematosus (SLE) patients. In contrast, histological lesions consistent with APS nephropathy were not associated with aPLs but with cardiovascular risk factors and worse renal outcome.

Methods

An evaluation of whether:
- use of platelet IHC markers improves the sensitivity of histological methods to detect microthrombosis in SLE nephritis and aPLs and
- to analyse the clinicopathological correlations of microthrombosis in this setting
Kidney biopsy specimens from 65 pts, including 36 with positive aPLs, were studied by IHC using Abs against platelet glycoproteins CD41 and CD61
Clinical data at the time of kidney biopsy and during a mean f/u of 7.5 yrs after biopsy were recorded and analysed with regard to histological or IHC data

Results

Histological lesions previously defined as APS nephropathy were found in 33% of the SLE kidney biopsies
They were not associated with positive aPLs
Microthrombi detected as intravascular CD61+ platelet deposits were present in 43% of the tissues
They were associated with positive aPLs, but not with histological APS nephropathy, nephritis manifestations nor with renal outcome
Histological APS lesions but not CD61+ microthrombi correlated with an older age at nephritis presentation, previous CV risk factors and worse renal outcome

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