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Significance of Persistent Antiphospholipid Antibodies in the Elderly
THOMAS QUÉMÉNEUR, MARC LAMBERT, ERIC HACHULLA, SYLVAIN DUBUCQUOI, CLAUDINE CARON, ANNE-LAURE FAUCHAIS, BERNARD DEVULDER, and PIERRE-YVES HATRON ABSTRACT. Objective. The prevalence of anticardiolipin antibodies (aCL) and of vascular diseases increases with age, and aCL may be associated with various diseases in the elderly. So the significance of aCL in the elderly remains difficult to determine. We sought to determine the significance of persistent antiphospholipid antibodies (aPL) in the elderly. Methods. We retrospectively analyzed the files of 327 patients [149 patients with antiphospholipid syndrome (APS); 64 patients age ≥ 65 yrs] with 2 positive aPL [lupus anticoagulant (LAC) and/or aCL]. Results. The frequency of APS was 40.8% (n = 134) in our 263 young patients (< 65 yrs) and 23.4% (n = 15) in our 64 elderly patients (≥ 65 yrs). The clinical characteristics of patients with persistent aPL were the same in those under and over 65 years. LAC was positive in all but one elderly patient with APS, and occurred in this group more frequently than in the young patients (93.3% vs 44.6%; p < 0.006). The presence of LAC allowed to discriminate APS patients in our elderly population (93.3% in APS vs 48.9% in non-APS patients; p < 0.009). Conclusion. Interpretation of a positive determination of APL is difficult in the elderly; persistent LAC may be the most valuable biological marker of APS in the elderly. (First Release July 1 2006; J Rheumatol 2006;33:1559–62) Key Indexing Terms:
LUPUS ANTICOAGULANT From the Departments of Internal Medicine and Immunology, Huriez Hospital, CHRU Lille, and University of Lille II, Lille, France. T. Quéméneur, MD; M. Lambert, MD, PhD; E. Hachulla, MD, PhD, Department of Internal Medicine; S. Dubucquoi, MD, PhD, Department of Immunology; C. Caron, MD, PhD, Department of Hemostasis; A-L. Fauchais, MD; B. Devulder, MD; P-Y. Hatron, MD, Department of Internal Medicine. Address reprint requests to Dr. M. Lambert, Service de Médecine Interne, 1 place de Verdun, Hôpital Claude Huriez, CHRU Lille, 59035 Lille cedex, France. E-mail: m-lambert@chru-lille.fr Accepted for publication March 28, 2006.
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