Résumé
Introduction: Anti phospholipids antibodies (aPL) can be
circulating during connectivitis without clinical
manifestations. Their prevalence in the general caucasian
population is low but can reach 55% in lupus and 57.5% in
systemic scleroderma. In sub-Saharan Africa, the
prevalence of these antibodies during systemic diseases is
unknown. Earlier studies conducted have mainly focused
on their clinical détails linked to a connectivitis.
Objective: To determine the frequency of aPL and their
morbidities when associated with systemic autoimmune
diseases among a Sub-Saharan population.
Patients and methods: We conducted a cross-sectional
multicenter study with prospective recruitment in Le
Dantec Hospital Internal Medicine and Dermatology
departments and also dermatology department of the Social
Hygiene Institute of Dakar. All patients with a systemic
autoimmune disease and who agreed to the informed
consent form were included. Test Samples for aPL
detection were conducted in the Hematology laboratory of
Le Dantec Hospital. A 12-week interval control sample was
performed for each patient who presented a positivity for
one or more antibodies. The diagnosis of antiphospholipid
syndrome (APS) was based on the Sydney classification
criteria. Socio-demographic, clinical and paraclinical data
were collected. Statistical analysis was performed using
Epi-info 7.2 software. A p-value (less than) ≤ 0.05 was
statistically significant.
Results: Sixty patients with systemic autoimmune diseases
were enrolled including 54 women (sex ratio=0.11). The
mean age was 41.15 years. The aPL frequency was 60%
(n=36) at the first blood test while the control test was
positive at 33.3% (n=10). Lupus anticoagulant (LA) was
positive in 35 patients corresponding to 58.3% and
anticardiolipin (ACL) antibodies in 2 patients representing
3.3%. No β2-glycoprotein antibodies (aβ2-GP1) were
detected. Five cases of APS were identified representing
8,4% of the sample. Five patients who didn’t meet the
diagnosis criteria of APS (Sydney) were persistently aPL
positive. Obstetric complications predominated with a
statistical significance p=0.04. Cutaneous and digital
ulcerations were not significantly correlated with APL
(p=0.34 p=0.17). Headaches were observed in 78% of Apl
positive cases without any statistical significance
(p=0.298). A similar result was observed for Raynaud’s
phenomenon (p=0.306).
Conclusion: aPL are frequently positive during
connectivitis but often transient. LA is the most common
antibody and SLE is the main cause.
Key words: connectivitis - antiphospholipid antibodies -
antiphospholipid syndrome - sub-saharan africa.
article Intégral
Fort JG, Cowchock FS, Abruzzo
JL, Smith JB. Anticardiolipin
antibodies in patients with rheumatic
diseases. Arthritis Rheum. 1987; 30(7):
-60
Anjali S, Suncica V, Claudia V and
William S (2014, november).
Antiphospholipid Antibodies in
Systemic Sclerosis: Prevalence and
Clinical Significance? Communication
presented at ARHP Annual Meeting,
Chicago.
On line
https://acrabstracts.org/abstract/antip
hospholipid-antibodies-insystemicsclerosis-prevalence-andclinical-significance/
Diallo M, Niang SO, Kane A, Dieng
MT, Ndiaye B. Antiphospholipid
antibodies
syndrome
in
dermatology
in
Dakar:
case.
Dakar
Med. 2007; 52(1): 41-5
Anjali S, Suncica V, Claudia V and
William S (2014, november).
Antiphospholipid Antibodies in
Systemic Sclerosis: Prevalence and
Clinical Significance? Communication
presented at ARHP Annual Meeting,
Chicago.
On line
https://acrabstracts.org/abstract/antip
hospholipid-antibodies-insystemicsclerosis-prevalence-andclinical-significance/
Touré AO, Ly F, Sall A, Diatta A, Gadji
M, Seck M et al. Antiphospholipid
antibodies and systemic scleroderma.
Turk J Hematol 2013; 30: 32-36
Miyakis S, Lockshin MD, Atsumi T et
al. International consensus statement
on an update of the classification
criteria for definite antiphospholipid
syndrome (APS). J Thromb Haemost
; 4(2): 2295-3067
Pattison NS, C hamley LW, Mac Key
EJ, Liggins GC. Antiphospholipid antibodies in
pregnancy: prevalence and clinical
associations. British Journal of
Obstetrics and Gynecology 1993,
(100):909-913
Chakravarty KK, Al-Hillawi AH,
Byron MA, Durkin CJ.
Anticardiolipin antibody associated
ischemic strokes in elderly patients
without systemic lupus erythematosus.
Age Ageing 1990; 19: 114-118
Diatta A, Touré-Fall AO, Sarr NG,
Diallo F, Diagne I, Lopez-Sall P et al.
Prevalence of antiphospholipid
antibodies in patients with sickle cell
disease. Ann Biol Clin. 2004; 62(3):
-4
Dioussé P, Berthé A, Dione H, Touré
PS, Bammo M, Seck F et al. Profil
épidémio-clinique des maladies autoimmunes
systémiques dans un service
de Dermatologie. RAFMI 2017 ; 4 (2) : 18-21
Sangaré et al.
Dermatological Manifestations of
Connective Tissue Diseases in Black
People.
J Clin Exp Dermatol Res 2015, 6:2
Cervera R et al.
Antiphospholipid Syndrome Clinical
and Immunologic Manifestations and
Patterns of Disease Expression in a
Cohort of 1,000 Patients. Arthritis
Rheum. 2002; 46(4): 1019-27
Sobanski V, Lemaire-Olivier A,
Giovannelli J, Dauchet L, Simon M,
Lopez B et al.
Prevalence and Clinical Associations of
Antiphospholipid Antibodies in
Systemic Sclerosis: New Data from a
french cross-sectional study, systematic
review, and meta-analysis.
Front immunol 2018; 9: 2457
Juby AG, Davis P.
Prevalence and disease associations of
certain autoantibodies in elderly
patients. Clin. Invest. Med 1998; 21: 411
Kwang-Sook W, Kyung-Eun K, Jeong
MK, Jin-Yeong H, Won-Tae C,
Kyeong-Hee K.
Prevalence and Clinical Associations of
Lupus Anticoagulant, Anticardiolipin
Antibodies, and Anti-beta2-
glycoprotein I Antibodies in Patients
with Systemic Lupus Erythematosus. Korean J Lab Med 2010; 30: 38-44
Perez MC, Wilson WA, Brown HL,
Scopelitis E.
Anticardiolipin antibodies in
unselected pregnant women in
relationship to fetal outcome.
J Perinatol. 1991; 11 (1): 33-6
Micah T. McClain, Melissa R.
Arbuckle, Latisha D. Heinlen, Gregory
J. Dennis, Jon Roebuck, Mark V.
Rubertone et al. The Prevalence,
Onset, and Clinical Significance of
Antiphospholipid Antibodies Prior to
Diagnosis of Systemic Lupus
Erythematosus Arthritis Rheumatism
50(4) : 1226-1232
Sanna G, Bertolaccini ML, Mameli A,
Hughes GR, Khamashta MA, Mathieu
A. Antiphospholipid antibodies in
patients with scleroderma: prevalence
and clinical significance. Ann Rheum Dis 2005; 64: 1795-1796
Samar A, Zareen A, Bookman AA,
Zahi Touma Z, Sanchez-Guerrero J,
Mitsakakis N et al.
Epidemiology and Survival of Systemic
Sclerosis- Systemic Lupus
Erythematosus Overlap Syndrome.
J Rheumatol. 201845(10): 1406-1410
Allaoui A , Echchilali k, Moudatir M,
Alaoui FZ, Elkabli H.
Etiologies des accidents vasculaires
cérébraux ischémiques chez les jeunes :
apport de l’interniste.
Pan Afr Med J. 2018; 30: 114
women cohort. Thromb Haemost. 2009;
(1): 25-8
Ben Salem T, Bensalem W, Ben
Ghorbel I, Khanfir M, Said F,
Hamzaoui A et al.
Syndrome des anticorps
antiphospholipides : à propos de 51 cas.
La Revue de médecine interne 2015 ;
: 76-185
Kanon J, Bhoopat L, Hanvivadhanakul
P. Clinical and immunological
characteristics of antiphospholipid
syndrome in an Asian population: a
retrospective study. Asian Pacific
Journal of Allergy and Immunology
; 37: 171-178
Zinebi A, Kechna H, Eddou H,
Moudden MK, El Baaj M. Pseudotumeur cardiaque révélant un
syndrome des antiphospholipides. Int J Innovation and Applied Studies
; 20(4): 1053-1056
Sridevi and Raju.
Antiphospholipid antibody syndrome:
an overview J Indian College of
Cardiology 2011; 1(2): 79-97.
Unlü O, Zuily S, Erkan D.
The clinical significance of
antiphospholipid antibodies in
systemic lupus erythematosus.
Eur J Rheumatol 2016; 3(2): 75-84
Boffa MC, Boinot C, De Carolis S,
Rovere-Querini P, Aurousseau MH,
Allegri F et al.
Laboratory criteria of the obstetrical
antiphospholipid syndrome. Data from
a multicentric prospective European
Zuily S, Wahl D.
Pulmonary hypertension in
antiphospholipid syndrom.
Curr Rheumatol Rep 2015; 17: 478
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