Michele Mastroberardino, MD, FCCP(*); Antonio Ciampa, MD; Paolino Papa, MD; Luigi Grosso, MD; Antonella Argenziano, MD; Antonio Iannaccone, MD; Fiorenza Prizio, MD and Domenico Bizzarro, MD. Pulmonary Medicine, Azienda Ospedaliera San Giuseppe Moscati, Avellino, Italy; Haemathology, Azienda Ospedaliera San Giuseppe Moscati, Avellino, Italy and Pulmonary Rehabilitation, Casa di Cura Villa Margherita, Benevento, Italy.
PURPOSE: A mutual relation, which is likely to be very close, between the naturally occurring prevalence of Lupus Anticoagulant (LA) and Anticardiolipin Antibodies (ACA), and the outset of pulmonay micro-macroangiopathic disordes, has not been clearly demostrated yet. Several researches have been carried out in order to explain and ascertain the incidence and the exact recurrence of such a relation.
METHODS: 28 patients (14 males aged 39 to 75, 14 females aged 41 to 80) were investigated. The patients showed the following clinical features: 20 had pulmonary embolism (PE) and 8 patients had pulmonary hypertention (PH). The diagnostic investigation based on medical reports (anamnesis and physical examination); pulmonary scintigraphy and echography were also carried out. The reference values for all the tests were obtained by a group consisting of 50 healthy volunteers (25 males and 25 females, aged 18 to 60). Several essay systems were used in order to detect the presence of LA (screening tests)and to confirm the antiphospholipid nature of the inhibitor (confirmatory test). The following screening tests were carried out: Prothrombine Time (PT), Partial Thromboplastin Time (PTT), Kaolin Clotting Time (KCT), Tissue Thromboplastin Inhibition Test (TTIT) and the Diluite Russels Viper Venom (DRVVT), while the Platelet Neutralization Procedure (PNP) was carried out as a confirmation test. ACA levels (IgG and IgM isotypes) were determined by a standardized MELISA.
RESULTS: The results are shown in the following chart:
CONCLUSION: An evidence of statistical incidence of Antiphospholipid Antibodies in the patients affected by pulmonary pathologies is proved by our researches.
CLINICAL IMPLICATIONS: LA and ACA are closely related to phospholipid binding antibodies which interfere, in a number of laboratory tests. Their presence has been detected for a long time in the plasma and serum of patients suffering from different pathologies, and we think that it could interfere in pathophysiology of PE.
GRANT SUPPORT: Azienda Ospedaliera San Giuseppe Moscati, Avellino.
COPYRIGHT 2000 American College of Chest Physicians
COPYRIGHT 2001 Gale Group