Primary antiphospholipid syndrome evolving into systemic lupus erythematosus: report of three new cases and review of the literature

The antiphospholipid syndrome (APS) is characterized by the presence of ven ous and arterial thrombosis, fetal losses, and thrombocytopenia, associated with the presence of antiphospholipid antibodies (aPL), This syndrome may be <<primary>> or associated with other diseases, particularly systemic lup us erythematosus (SLE). There is considerable debate on the interrelations between primary APS and SLE as well as on the value of the American College of Rheumatology (ACR) criteria to distinguish between both entities. Sever al authors have suggested that some patients with primary APS may ultimatel y develop SLE. Likewise, some authors have proposed exclusion criteria for primary APS. The presence of any of these criteria in a patient with the in itial diagnosis of APS might indicate progression to SLE. Three new cases a re here reported in whom the diagnosis evolved into SLE some years after th e initial diagnosis of primary APS was made. Similar cases previously repor ted in the literature are reviewed.