The topic of Matsumi Ladies Clinic Mita English blog in May is about the 27th AOFOG conference.

In the first part, I create an article about the second presentation of our research with Dept. of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo.

 

The title of our presentation is 「Possible association of anti-beta2-glycoprotein I/HLA-DR complex antibody with systemic hypercoagulation and clinical outcomes of our clinic in patients with a history of recurrent pregnancy loss (RPL) 」.

The first author is Hirotaka Matsumi, the director of MATSUMI Ladies Clinic Mita, and the last author is Takeshi Nagamatsu, the associate professor of Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo.

Summary of our presentation is as follows.

 

[Objective]

Recurrent pregnancy loss (RPL) is one of clinical manifestations of antiphospholipid syndrome (APS).

Besides APS, disorders of thyroid function and immunity along with thrombophilia are other etiological reasons of this disease.

Recently, autoantibody against β2-glycoprotein I (β2GPI) complexed with HLA class II molecules (β2GPI/HLA-DR) has been reported to be a novel autoantibody related to APS.

The present study aimed to explore the association of anti-β2GPI/ HLA-DR antibody with coagulation-related biomarkers in women with RPL.

Furthermore, we represent data of clinical outcomes of our clinic in these patients.

 

[Methods]

Serum levels of conventional antiphospholipid antibodies (aPLs), including IgG/IgM anticardiolipin antibodies, anti-β2GPI antibody, and lupus anticoagulant were measured in forty-one women with history of RPL along with that of one miscarriage (the RPL group).

To evaluate coagulation status, serum levels of TAT, AT3 and D-dimer were also measured.

Other reasons of RPL, such as disorders of thyroid function and immunity along with thrombophilia and abnormality of uterine structure were also assessed.

 

[Results]

Conventional aPL antibodies were detected in 7/38 (18.4%), whereas anti-β2GPI/HLA-DR antibody was positive in 6/41 (14.6%).

There were two women showing double positive for aPLs and anti-β2GPI/HLA-DR antibody.

Elevation of TAT concentration was detected in 13/33 (39.4%) in the women with the RPL group.

Interestingly serum levels of TAT were commonly high in the women positive for anti-β2GPI/HLA-DR antibody implying that coagulation pathway was activated in those women.

Two of twenty pregnant patients were anti-β2GPI/HLA-DR antibody positive.

One with the treatment of LDA is pregnant at 18 weeks’ gestation and the other one without pharmacological intervention, resulting in miscarriage.

 

[Conclusion]

In some group of women with RPL, anti-β2GPI/HLA-DR antibody might be associated with systemic hypercoagulation, which is reflected by a coagulation marker of TAT．

 

The 27th AOFOG conference will be held since May 24th for three days.