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

Abstract

OBJECTIVE\nThis 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.\n\n\nMETHODS\nThis study included three groups: 1) healthy women (control, n\u202f=\u202f30); 2) women with low activity of the disease (SLEDAI 2\u202fK\u202f≤\u202f4, n\u202f=\u202f30); 3) women with active disease (moderate or high activity) (SLEDAI 2\u202fK\u202f>\u202f4, n\u202f=\u202f30). 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.\n\n\nRESULTS\nHigher 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.\n\n\nCONCLUSION\nR-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.