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Previous Volume 351:260-267 July 15, 2004 Number 3 Next

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ABSTRACT

Background Cardiovascular disease is an important complication in patients with systemic lupus erythematosus (SLE). Variant alleles of the mannose-binding lectin gene are associated with SLE as well as with severe atherosclerosis. We determined whether mannose-binding lectin variant alleles were associated with an increased risk of arterial thrombosis among patients with SLE.

Methods Mannose-binding lectin alleles were genotyped by means of a polymerase-chain-reaction assay in 91 Danish patients with SLE. Arterial and venous thromboses occurring after the diagnosis of SLE were assessed in a prospective study. Arterial and venous thromboses were confirmed by appropriate diagnostic methods.

Results Fifty-four patients had no mannose-binding lectin variant alleles (A/A genotype), 30 were heterozygous (A/O genotype), and 7 were homozygous (O/O genotype). During a median follow-up of 9.1 years, arterial thromboses (cerebral or myocardial infarction or leg embolus) developed in 6 of the 7 patients with the O/O genotype, as compared with 18 of the 84 patients with the other two genotypes (hazard ratio, 5.8; 95 percent confidence interval, 2.2 to 15.2; overall incidence, 26 percent). After correction for other known risk factors, the hazard ratio was 7.0 (95 percent confidence interval, 1.9 to 25.4). Venous thromboses, which occurred in 14 patients, were statistically unrelated to the mannose-binding lectin genotype.

Conclusions Among patients with SLE, homozygosity for mannose-binding lectin variant alleles is associated with an increased risk of arterial thrombosis. The risk of venous thrombosis is not increased, indicating that mannose-binding lectin has a specific role in providing protection against arterial thrombosis.

Source Information

From the Department of Rheumatology, Bispebjerg Hospital (T.Ø., S.J.); the Department of Rheumatology, Hvidovre Hospital (T.Ø., S.J.); and the Department of Rheumatology (T.Ø., S.J.) and the Tissue Typing Laboratory, Department of Clinical Immunology (T.Ø., P.G., H.O.M.), Rigshospitalet, University of Copenhagen — all in Copenhagen, Denmark.

Address reprint requests to Dr. Jacobsen at the Department of Rheumatology, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark, or at sj{at}dadlnet.dk.

Full Text of this Article

Related Letters:

Arterial Thrombosis in Systemic Lupus Erythematosus
Sabio J. M., Jiménez-Alonso J., Tanvetyanon T., Jacobsen S., Garred P.
Extract | Full Text | PDF  
N Engl J Med 2004; 351:1910-1911, Oct 28, 2004. Correspondence

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