Antibodies May Be Used to Detect Pulmonary Hypertension in Lupus Patients, Study Reports

Antibodies May Be Used to Detect Pulmonary Hypertension in Lupus Patients, Study Reports

Antiphospholipid antibodies (aPL) could signal that a lupus patient is at risk of developing pulmonary hypertension (PH) and related conditions, according to a study.

Researchers called for additional studies that would lead to doctors using the antibodies’ presence in blood to screen such patients and develop early treatment strategies for them.

The research, “Antiphospholipid antibodies can identify lupus patients at risk of pulmonary hypertension: a systematic review and meta-analysis,” was published in the journal Autoimmunity Reviews.

Lupus is an inflammatory autoimmune disease that affects many organs. Symptoms include rash, joint and muscle pain, kidney disorders, and neurological disorders.

APLs are associated with lupus development. Because lupus also affects PH patients, the antibodies are present in these patients as well. But it wasn’t clear until this study whether the presence of aPLs increased the risk of a lupus patient developing PH.

Researchers decided to check for a link between aPL and PH. They reviewed 31 studies covering 4,480 lupus patients and 410 PH patients to see if they could find a connection.

What they discovered was that 12.3 percent of lupus patients with the antibodies also had PH, versus 7.3 percent for those without the antibodies.

Importantly, the risk of a lupus patient with antibodies developing PH was twice as high as a patient without them. Patients with the antibodies also were at higher risk of developing conditions associated with PH.

Another finding was that lupus patients with a specific antibody — LA or IgG aCL — were at higher risk of developing PH than those with other aPLs.

“This [study] demonstrated that [lupus] patients with aPL have a two-fold increased risk of PH and [associated conditions] compared to those without these antibodies,” researchers wrote. “This identifies aPL as a potential biomarker for the risk-stratification of PH and [associated conditions] in [lupus] patients.”

When doctors discover that a lupus patient has the antibodies, “echocardiographic monitoring should be mandatory to screen pulmonary hypertension before referral for further evaluation for the confirmation and the treatment of PH,” the team added.

The research had limitations. For instance, the studies the researchers analyzed used different methods for quantifying PH and different criteria for establishing a diagnosis.

Despite this, the team said it hopes its analysis leads to research that develops the antibodies as a tool for identifying PH and related conditions in lupus patients. That way, doctors can screen lupus patients for PH and begin early treatment.

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3 comments

  1. Kathy L. says:

    This study does a disservice to those seronegative lupus patients, because more often than not clinicians then rely on that apls marker to make their diagnosis, thus the seronegative
    patient is told they don’t have lupus based on a single test result, when in fact they may have other strong clinical evidence
    of the disorder, but treatment that might have improved the quality of their lives’ is not going to be offered and they will
    continue to deteriorate until they succumb, and even then it’s
    unlikely any physician will change their diagnosis, because they don’t want to look incompetent. I have learned first hand what happens when a chance to diagnose is blatantly disregarded or casually overlooked, and 20+ years later that patient is not doing well at all.

  2. Kathy says:

    I could’ve told you this without the study. When my iGg raises, the chances of clotting increase. The clotting caused my PH, I have CTEPH. I had the PTE surgery but because of my lupus I continued to clot and now my PH is back and considered reaccurant. I am on monthly chemo infusions to keep my iGg under control. And when that’s not enough I go through 5 days of plasma pharesis to take out the antibodies. I obtained a grant from PHA a few years ago to educate blood doctors on the connection between clotting disorders and CTEPH. Hopefully this will further educate them.

  3. ann b wall says:

    I have now a “normal echo ” at rest. Had PH on resting echo still “normal ” by some clinicians , Stress Echo showed a PAS of 66 ! PH is a hidden disease in early stages when most treatable. Luckily I was diagnosed and treated by my wonderful Pulmonologist at Uof Penn . I feel like a miracle! ANY ATTENTION TO THIS DISEASE IS POSITIVE.

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