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Correlation between active disease and hypercoagulability state in patients with systemic lupus erythematosus

2018; Elsevier BV; Volume: 490; Linguagem: Inglês

10.1016/j.cca.2018.12.008

1873-3492

Karine Silvestre Ferreira, Walter Batista Cicarini, Luan Carlos Vieira Alves, Cristina de Mello Gomide Loures, Fernanda Magalhães Freire Campos, Luara Isabela dos Santos, Marcos Vinícius Ferreira da Silva, Tânia Mara Dabés Guimarães, Vicente de Paulo Coelho Peixoto de Toledo, Edna Afonso Reis, Cláudia Lopes Santoro Neiva, Renato Vargas Consoli, Paulo Madureira de Pádua, María das Graças Carvalho Ferriani,

Blood Coagulation and Thrombosis Mechanisms

This study has investigated whether high levels of Reticulocytes-C4d (R-C4d) and Platelets-C4d (P-C4d) reflecting recent activity in SLE patients are correlated with changes in natural anticoagulation components, coagulation activation and endothelial injury markers. This study included three groups: 1) healthy women (control, n = 30); 2) women with low activity of the disease (SLEDAI 2 K ≤ 4, n = 30); 3) women with active disease (moderate or high activity) (SLEDAI 2 K > 4, n = 30). Median fluorescence intensity (MFI) of R-C4d and P-C4d were determined by flow cytometry using double labeling with specific monoclonal antibodies. Endothelial injury and hypercoagulability were evaluated by measuring Thrombomodulin and D-dimer levels. Higher MFI index of R-C4d were related to the recent activity of SLE, and higher expression of P-C4d indicated an elevated risk of thrombotic complications. Increased levels of soluble thrombomodulin and D-dimer were observed in patients with active SLE. R-C4d is helpful to monitor early disease activity and PC4-d may be an important tool to detect a prothrombotic phenotype in SLE. Elevated levels of D-dimer and thrombomodulin add value to P-C4d data and corroborate a hypercoagulable profile in women with SLE, contributing to an increased prothrombotic risk associated with inflammation.