Association of IgA Anti-beta2 glycoprotein I with clinical and laboratory manifestations of systemic lupus erythematosus

J Rheumatol. 2011 Jan;38(1):64-8. doi: 10.3899/jrheum.100568. Epub 2010 Oct 15.


Objective: IgA isotypes of anticardiolipin and anti-ß(2) glycoprotein I (anti-ß(2)-GPI) are omitted from the revised antiphospholipid syndrome (APS) classification criteria. Multiple studies have found a high prevalence of IgA anti-ß(2)-GPI in systemic lupus erythematosus (SLE). We determined the frequency and associations of IgA anti-ß(2)-GPI in a cohort of patients with SLE.

Methods: anti-ß(2)-GPI was measured in 796 patients with SLE (93% women, 53% white, 38% African American, mean age 45 yrs). IgA anti-ß(2)-GPI (> 20 phospholipid units) was found in 20%. Using a cohort database, associations with cumulative thrombotic and other manifestations were determined.

Results: of patients with SLE who demonstrated IgA anti-ß(2)-GPI positivity, about 6% had transient ischemic attack (p = 0.070), 4% had superficial thrombophlebitis (p = 0.647), 20% had deep venous thrombosis (p = 0.003), 4% had other venous thrombosis (p = 0.827), 12% had stroke (p = 0.050), and 1% had myocardial infarction (p = 0.397).

Conclusion: IgG anti-ß(2)-GPI has the strongest association with thrombosis in SLE. However, IgA anti-ß(2)-GPI was more strongly associated with deep venous thrombosis and with stroke than was IgM. These results indicate that assessment of IgA anti-ß(2)-GPI is associated with thrombosis in SLE, and that the classification criteria for APS should be revised to include IgA anti-ß(2)-GPI in patients with SLE.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Autoantibodies / blood*
  • Female
  • Humans
  • Immunoglobulin A / blood*
  • Lupus Erythematosus, Systemic / immunology*
  • Lupus Erythematosus, Systemic / physiopathology*
  • Middle Aged
  • Young Adult
  • beta 2-Glycoprotein I / immunology*


  • Autoantibodies
  • Immunoglobulin A
  • beta 2-Glycoprotein I