PRIMARY ANTIPHOSPHOLIPID SYNDROME EVOLVING INTO SYSTEMIC LUPUS-ERYTHEMATOSUS

Since 1983 we have followed a total of 165 patients with antiphospholi pid syndrome (APS). During the median followup period of 78 mo (range 12-336 mo), 3 of 80 patients with primary APS subsequently developed f eatures of systemic lupus erythematosus (SLE) or lupus-like disease. O ne patient developed lupus-like disease 4 yrs and the other 2 develope d full blown SLE more than 10 yrs after initial presentation of primar y APS. Tissue typing in patients who developed SLE showed HLA antigens A2, A3, B35, Bw6, Cw4, DR7, DRw53, and DQ2 (Case 2); and A1, A3, B7, B8, Bw6, Cw7, DR4, DR15, DR51, DRw53, and DQ1 (Case 3). We report clin ical features and genetic associations of these 3 patients.