MARKERS OF VASCULAR DAMAGE IN LUPUS PREGNANCY

Objective: To study serum levels of von Willebrand factor antigen (vWF :Ag) and anti-endothelial cell antibodies (AECA) in pregnancies with s ystemic lupus erythematosus (SLE) compared so healthy pregnancies and to evaluate their correlation with disease activity and fetal outcome. Methods: Twenty-four patients with SLE were compared with 26 healthy pregnancies. vWF:Ag and AECA levels were measured by ELISA. Results: I n lupus pregnancies vWF:Ag and AECA levels were significantly elevated compared to healthy pregnancies (vWF:Ag: 255 +/- 160%, 10/24 positive vs 135 +/- 59%, 1/26 positive, p = 0.006; AECA Binding Index: 36 +/- 29%, 5/24 positive vs 17 +/- 16%, 1/26 positive, p = 0.002). When samp les taken during follow-up were evaluated vWF:Ag was positive in 21/27 (78%) of the samples during exacerbations compared to 4/25 (16%) in r emission. Only 5/27 (19%) of the samples during exacerbations and none during remission were positive for AECA. Samples during three pregnan cy failures were positive for vWF:Ag, but not for AECA. Of the 13 samp les taken from the mothers of 4 babies with neo-natal lupus, 10 were p ositive for vWF:Ag and three for AECA. No correlations of anti-cardiol ipin antibodies (aCL) were seen either with vWF:Ag or AECA titres. Con clusion: Compared to healthy pregnancies, vWF:Ag and AECA levels are i ncreased in lupus pregnancies, vWF: Ag levels also correlated with act ive disease.