Anti-phospholipid antibodies in systemic autoimmune diseases: a study among a sub-Saharan population
Saer DIADIE, Awa Oumar TOURE, Fatimata LY, S S SOULANOUDJINGAR, K DIOP, F B SALL, R HOUDA, Baïdy Sy KANE, N NDOUR, M DIALLO, Suzanne Oumou NIANG

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

Dernières publications


Tuberculose compliquant l’évolution d’une leucémie myéloïde chronique. A propos de deux cas dans le service d’hématologie du CHU de Cocody
Syndrome malin des neuroleptiques révélateur d’une hyperthyroïdie primaire chez une femme de 54 ans : à propos d’un cas
Syndrome douloureux abdominal révélateur d’une thrombose insolite à localisation portale : à propos de 2cas
La péricardite aigue, un mode exceptionnel de présentation de la maladie de Still de l’adulte