FIBRINOLYSIS AND COAGULATION ABNORMALITIES IN SYSTEMIC LUPUS-ERYTHEMATOSUS - RELATIONSHIP WITH RAYNAUDS-PHENOMENON, DISEASE-ACTIVITY, INFLAMMATORY INDEXES, ANTICARDIOLIPIN ANTIBODIES AND CORTICOSTEROID-THERAPY

Endothelial cell damage in systemic lupus erythematosus (SLE) was eval uated by measuring fibrinolytic activity and von Willebrand factor lev els. Tissue-type plasminogen activator (t-PA) antigen, plasminogen act ivator inhibitor (PAI) activity, and von Willebrand factor antigen (vW F:Ag) and activity (vWF:RCof) were measured in 21 SLE patients (12 of whom were therapy free) and 22 controls. In addition, the relationship between such parameters and Raynaud's phenomenon, disease activity [a ccording to personal criteria, Systemic Lupus Activity Measure (SLAM) and European Consensus Lupus Activity Measurement (SLAM) scores], infl ammatory indices [ESR, C-reactive protein (CRP), alpha(2)-globulin], a nticardiolipin antibodies and corticosteroid therapy was investigated. Lower levels of t-PA antigen (P = 0.003) and higher levels of vWF:Ag (P = 0.001) were found in SLE patients in comparison with controls. Mo reover, t-PA antigen was lower (P=0.02) in steroid-free patients in co mparison with those taking steroids. No relationship was found between fibrinolysis and coagulation abnormalities and Raynaud's phenomenon, disease activity, inflammatory indices and anticardiolipin antibodies. Endothelial cell damage is probably a common feature in SLE patients; nervertheless, we were unable to clarify the nature of such abnormali ty. It is worth noting that low doses of steroids seem to be effective in improving endothelial cell function in SLE patients.