ANTIPHOSPHATIDYLETHANOLAMINE ANTIBODIES AS THE ONLY ANTIPHOSPHOLIPID ANTIBODIES .1. ASSOCIATION WITH THROMBOSIS AND VASCULAR CUTANEOUS DISEASES

Objective. To detect antiphosphatidylethanolamine antibodies (aPE) as the only antiphospholipid antibodies (aPL) in 122 patients we investig ated for aPL and to correlate the presence of aPL with clinical manife stations. Methods. Patients with autoimmune diseases (n = 41), thrombo embolic episodes (TEE) (n = 34), livedo reticularis (LR) without (n = 17) or with (n = 14) thrombosis or recurrent fetal losses (RFL), syste mic vasculitides (n = 10), and miscellaneous disorders (n = 6) were in vestigated for antibodies directed against 4 anionic phospholipids (PL ) (cardiolipin, phosphatidylserine, inositol, phosphatidic acid) and l upus anticoagulant (LAG) and then for aPE by modified ELISA. Results. 15 patients had aPE and no antibodies to anionic PL including LAG. 7 h ad IgM, 4 had Ige plus IgM, and 4 had IgG. These aPE were significantl y more often associated with TEE alone, with TEE and LR, or with LR al one (p = 0.004) than with autoimmune diseases. Conclusion. The detecti on of aPE as the sole aPL in one patient with mesenteric infarcts and RFL led to the diagnosis of primary antiphospholipid syndrome. Followu p of 3 patients showed that aPE cannot be considered as transient auto antibodies. Therefore, patients whose clinical symptoms suggest antiph ospholipid syndrome but whose sera are negative for-antibodies to card iolipin or another anionic PL, should be screened for aPE, particularl y patients with thrombosis, RFL, and/or LR.