Detection of antibodies associated with anti-phospholipid syndrome in patients with syphilis

Little is known about the behavior of antibodies associated with anti-phospholipid syndrome in syphilis. To investigate the patterns of antibodies associated with anti-phospholipid syndrome production in syphilitic infection. The serum level of anti-phospholipid antibodies was measured in 394 patients with different forms of syphilis, 85 of which were followed after treatment. The patients included in the study had complete anamnestic data that met all the necessary diagnostic criteria, and underwent all types of clinical and laboratory examinations to establish the diagnosis. To detect anti-bodies the ThromboCombo IgG/IgM ELISA Kit, Anti-Cardiolipin Screen, Anti-Cardiolipin ELISA (IgAGM), Anti-β2-Glycoprotein 1 ELISA (IgAMG) were used. The cut-off values for positive results were determined based on the manufacturer's recommendations. Comparisons of qualitative features were carried out using the chi-squared test (χ²) or Fisher tests, quantitative – t-test or Mann – Whitney U-test, with the level of significance adjusted to identify significantly different pairs in multiple comparisons using the Bonferroni procedure. The paired t-test or the Wilcoxon test was used to compare quantitative traits in related samples. Spearman's rank correlation method was used to assess the relationship. Anti-cardiolipin antibodies occurred with the greatest frequency in patients with secondary syphilis (81%). The frequency of anti-cardiolipin antibodies was significantly higher in primary (49%) and early latent (52%) syphilis compared with late latent syphilis (18%), neurosyphilis (15%) and serofast state (17%). The anti-cardiolipin antibodies level decreased shortly after initiation of treatment in patients with early syphilis, and lasted years at low values without changes in patients with late syphilis. The proportion of patients testing positive for beta-2-glycoprotein I antibodies did not differ significantly in all forms of syphilis (13-21%). No significant antibody response to phosphatidyl serine, phosphatidyl inositol, phosphatidic acid was observed in the patients with syphilis. Anti-cardiolipin antibodies may play a role in the development of complications in early stage syphilis and have utility in early diagnosis of syphilis, diagnosis of reinfection, and differential diagnosis of early and late forms. The screening for syphilis is recommend in subjects with first-episode of raised level of anti-cardiolipin antibodies.

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