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Antiphospholipid antibodies in patients with venous thrombosis at Kenyatta National Hospital
Abstract
Objective: To determine the presence and types of antiphospholipid antibodies in patients with venous thrombosis at Kenyatta National Hospital.
Design: A cross-sectional descriptive study.
Setting: This study was conducted at Kenyatta National Hospital (KNH), a major referral and teaching hospital in Nairobi, Kenya, between January and November 2011. The study areas included the Accident and Emergency department, wards and outpatient clinics, and the Haematology and Immunology laboratories.
Participants: Male and female adult patients diagnosed with venous thrombosis confirmed by Doppler ultrasound or MRI.
Main outcome measures: Age, gender, presence or absence of lupus anticoagulant, and titres of anticardiolipin (ACL) and anti-2-GP1 antibodies (anti-2GP1).
Materials and Methods: Demographic and clinical information was collected by direct interview of patients. Every patient was examined for clinical manifestations of APA and blood drawn for laboratory tests. A proforma questionnaire was used to collect all the information. The data collected was pooled, screened and entered into SPSS v.19 software for analysis.
Results: A total of 60 patients were studied. Majority of the patients, 52 (86.7%), were females, while males were 8 (13.3%). The mean age was 38.3 years (± 13.7), with a median (IQR) of 52 years (38.8, 58) for males vs. 32.5 years (24.8, 43.5) for females, p value <0.05). The mean APTT value was 38.4 seconds (± 15.1) with 20 patients (33.3%) having prolonged values. Two patients (10%) had a prolonged KCT (RI >0.16; positive for LA), and all 20 (100%) who had a prolonged APTT had a negative DRVVT (NR <1.30; negative for LA). The mean anticardiolipin IgG titre was 107.4 U/mL (SD ± 62.4); 55 patients (91.7%) had a positive ACL result. The media anti-beta-2-glycoprotein IgG titre was 5 G units (IQR= 4.5, 6.5); 55 patients (91.7%) had a negative result. A signi cant positive correlation existed between APTT and ACL (r=0.39) and between ACL and 2GP1 (r=0.30).
Conclusions: Antiphospholipid antibodies (LA and anti-2GP1 IgG antibodies) are present in a very small proportion of patients seen at KNH with venous thrombosis. ACL IgG antibodies may be induced by numerous factors and may not be related to thrombosis. Pathological antiphospholipid antibodies are uncommon in patients seen at KNH with VTE.
Design: A cross-sectional descriptive study.
Setting: This study was conducted at Kenyatta National Hospital (KNH), a major referral and teaching hospital in Nairobi, Kenya, between January and November 2011. The study areas included the Accident and Emergency department, wards and outpatient clinics, and the Haematology and Immunology laboratories.
Participants: Male and female adult patients diagnosed with venous thrombosis confirmed by Doppler ultrasound or MRI.
Main outcome measures: Age, gender, presence or absence of lupus anticoagulant, and titres of anticardiolipin (ACL) and anti-2-GP1 antibodies (anti-2GP1).
Materials and Methods: Demographic and clinical information was collected by direct interview of patients. Every patient was examined for clinical manifestations of APA and blood drawn for laboratory tests. A proforma questionnaire was used to collect all the information. The data collected was pooled, screened and entered into SPSS v.19 software for analysis.
Results: A total of 60 patients were studied. Majority of the patients, 52 (86.7%), were females, while males were 8 (13.3%). The mean age was 38.3 years (± 13.7), with a median (IQR) of 52 years (38.8, 58) for males vs. 32.5 years (24.8, 43.5) for females, p value <0.05). The mean APTT value was 38.4 seconds (± 15.1) with 20 patients (33.3%) having prolonged values. Two patients (10%) had a prolonged KCT (RI >0.16; positive for LA), and all 20 (100%) who had a prolonged APTT had a negative DRVVT (NR <1.30; negative for LA). The mean anticardiolipin IgG titre was 107.4 U/mL (SD ± 62.4); 55 patients (91.7%) had a positive ACL result. The media anti-beta-2-glycoprotein IgG titre was 5 G units (IQR= 4.5, 6.5); 55 patients (91.7%) had a negative result. A signi cant positive correlation existed between APTT and ACL (r=0.39) and between ACL and 2GP1 (r=0.30).
Conclusions: Antiphospholipid antibodies (LA and anti-2GP1 IgG antibodies) are present in a very small proportion of patients seen at KNH with venous thrombosis. ACL IgG antibodies may be induced by numerous factors and may not be related to thrombosis. Pathological antiphospholipid antibodies are uncommon in patients seen at KNH with VTE.
