Full Text
Abstract
Aim: to assess the importance of hyperhomocysteinemia (HHC) as an additional risk factor for thrombosis in systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS).
Materials and methods. We examined 125 patients: 51 patients with SLE, 25 patients with isolated «primary» APS (PAPS) and 49 patients with a combination of SLE and APS.
Results. HHC was revealed in 82 from 125 (66%) patients: in 30 from 51 (59%) patients with SLE, in 33 from 49 (67%) patients with a combination of SLE and APS, and in 19 from 25 (76%) with PAPS. In lupus patients HHC was more often (p = 0.04) in men (86%) than in women (60%). Homocysteine (HC) blood level was higher in SLE patients with the disease activity 11–20 points according to SLEDAI scale than in those with activity 5–10 points (20.3±8.4 vs. 14.5±5.8 μg/l; р<0.05). HHC was significantly more frequently observed in patients with digital necroses and discoid lupus erythematosus. HC blood level in patients with SLE did not depend from kidney involvement. Increasing of HC blood level was registered in 43 from 55 (78%) patients with APS vs. 9 from 19 (47%) patients with antiphospholipid antibodies without thrombosis (odds ratio 3.98; 95% CI=1.16–13.98; p=0.03). HHC was more frequently revealed in patients with cerebral, coronary and peripheral artery thromboses and also inferior vena cava thrombosis in patients with Budd–Chiari syndrome. HС blood level was higher in patients with arterial thrombosis with a post-thrombotic period (PTP) less than 2 months (22.9±7.0 μg/l) than in those with PTP over 2 years (16.6±3.7 μg/l).
Сonclusion. HHC frequency in examined patients was 66%, predominantly in PAPS patients (76%). HHC in SLE was associated with male sex. HHC can be considered as an independent risk factor for thrombosis in both primary and secondary ASF. Increasing of HC blood level in patients with APS was associated with cerebral and peripheral arterial thromboses and coronary artery disease. HC blood content was higher in the first months after thrombosis as compared with the long-term period after thrombosis (2 years or more).
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