Antibodies to annexin-5 in pregnant women with systemic lupus erythematosus

Objective. To assess change of annexin-5 antibodies (AA5) level and AA5 influence on gestation outcome in pregnant women with systemic lupus erythematosus (SLE).

Material and methods. 15 pregnant women with SLE who fulfilled 1997 ACR criteria (4 of them with concomitant antiphospholipid syndrome – APS) were included. Median age of pts was 28,0 (23- 33) years, median SLE duration – 4,0 (3-9) years. SLEDAI activity score at the beginning of gestation was 2 (2-11). All but one pts received metypred from 2 to 20 mg/day. The women were examined in every trimester of gestation. AA5 and anticardiolipine antibodies (ACLA) were evaluated with immunoenzyme assay.

Results. AA5 elevation was revealed in 7 women (group 1): 6 of them were only IgG AA5 positive, 1 had both IgG and IgM AA5. Isolated IgM AA5 elevation was absent. 4 pts had borderline IgG AA5 values (from 5,3 to 7,4 U/ml). 3 pts had respectively 9,6, 12,1 and 168,5 U/ml. The last pt was also positive for IgM AA5 (till 14,4 U/ml). AA5 elevation was more frequent and more prominent during the II trimester of gestation. 8 pts with SLE (group 2) did not have AA5 elevation. 11 from 15 gestations ended with birth of viable baby, the rest 4 had unfavorable outcome. Median terms of delivery did not differ in both groups and came to 36 weeks. 3 pts with normal AA5 and 1 pt with elevated AA5 had gestation lost. 3 from these 4 pts were ACLA positive and APS was earlier diagnosed in 2 from them.

Conclusion. Almost half of pregnant women with SLE (7 from 15) had AA5 elevation mainly during the II trimester of gestation. Unfavorable gestation outcomes were not associated with AA5 elevation. Possibly low levels of AA5 positivity and small sample size could influence the results.

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