AB0596 The immune complexes of igg/igm bound to b-2-glycoprotein i are associated with livedo reticularis, thrombocytopenia and sicca in aps patients

Background Several manifestations strongly associated with APS have been excluded as classification criteria.1 2 Objectives The aim of this study was to investigate correlation between circulating immune-complexes of IgG or IgM antibodies bound to B2GPI (B2G-CIC and B2M-CIC) and clinical manifestations in Serbian cohort of APS patients. Methods A total of 57 patients with APS were evaluated: 35 with PAPS and 22 patients with SAPS. Mean age was 47.6±1.6 years; 36 (63.2%) were women. All patients have met the 2006 revised Sydney criteria for APSQuantification of B2G-CIC and B2M-CIC levels was performed as previously, for detect B2G-CIC was used anti-human IgG HRP-conjugate and for B2M-CIC human IgM HRP- conjugate, both from INOVA (INOVA Diagnostics Inc., San Diego, CA, USA). Results In our cohort Serbian APS patients the prevalence of CIC was 19.29% (11/57); 8 patients with B2M-CIC and the remain 3 patients with B2G-CIC. Livedo reticularis was diagnosed with higher prevalence in patients with CIC compared with patients without CIC; 63.6% and 23.9%, respectively (OR: 5.57, p=0.01). In patients with CIC, thrombocytopenia and leukopenia were more prominent; 54.4% vs 17.4% (OR: 5.70, p=0.01) and 45.5% vs 13.0% (OR: 5.56, p=0.01), respectively. Ophthalmic sicca was more prevalent in patients with CIC; 54.4% vs 8.7% (OR: 12.6, p<0.001). Although complement consumption was more frequent in patients with CIC (figure 1). Figure 1 Mean levels of C3 (A) and C4 (B) complement in groups. Mean levels of C3 (115.6±9.2 mg/dL and 140.9±4.3 mg/dL, group-1 and group-2 respectively) and mean levels of C4 (140.9±4.3 mg/dL and 30.8±1.6 mg/dL, group-1 and group-2, respectively). Conclusions B2G-CIC and B2M-CIC are strongly associated with clinical manifestations related to APS. Widening the APS spectrum is indispensable to better understand this syndrome. References [1] Stojanovich L, Kontic M, Djokovic A, Marisavljevic D, Ilijevski N, Stanisavljevic N, et al. Association between systemic non-criteria APS manifestations and antibody type and level: results from the Serbian national cohort study. Clin Exp Rheumatol. 2013 Mar-Apr;31(2):234–42. [2] Stojanovich L, Markovic O, Marisavljevic D, Elezovic I, Ilijevski N, Stanisavljevic N. Influence of antiphospholipid antibody levels and type on thrombotic manifestations: results from the Serbian National Cohort Study. Lupus. 2012Mar;21(3):338–45. Acknowledgements This work was supported by research grant number 175041, and TR 32040 for 2011–2018, issued by the Ministry of Science of the Republic of Serbia. Disclosure of Interest None declared