INHERITED THROMBOPHILIAS COULD INFLUENCE THE REPRODUCTIVE OUTCOME IN WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS
robeva r1,*, Tanev D2, andonova S3, Nikolova M4, Tomova a1, Kumanov Ph1, Savov a3, Rashkov R2, Kolarov Zl2,*
*Corresponding Author: Professor Zlatimir Kolarov, M.D., Ph.D., D.MSc., Clinic of Rheumatology, Medical University Sofia, 13 Urvich Str., Sofia 1612, Bulgaria. Tel: +359-2-958-93-91. Fax. +359-2-958-23-31. E-mail: zkolarov@abv.bg and Ralitsa Robeva, M.D., Ph.D., Clinical Center of Endocrinology and Gerontology, Medical University Sofia, 2 Zdrave Str., Sofia 1431, Bulgaria. Tel: +359-2-895-60-40. Fax: +359-2-987-41-45. E-mail: rali_robeva@yahoo.com
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INTRODUCTION

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that could increase the risk for adverse pregnancy outcomes in affected women because of the associated hypercoagulability [1]. The SLE exacerbations, active SlE at conception, presence of anti-phospholipid antibodies, lupus nephritis and hypertension have been reported as important risk factors for obstetric complications [2,3]. However, the role of genetically determined thrombophilias for women with SLE has not yet been completely clarified. A well-known prothrombotic factor is the single nucleotide substitution in the factor V gene (rs6025, G>A substitution at nucleotide position 1691), which encodes a resistant to activated protein C molecule (Factor V Leiden) [4]. Other common thrombophilias include a prothrombin gene G20210A variant (rs1799963) that has been associated with elevated prothrombin activity as well as C>T transition at base pair 677 of the methylenetetrahydrofolate re-ductase (MTHFR) gene (rs1801133) (CC, CT and TT genotypes), which has been related to increased plasma homocysteine levels [5,6]. Several studies have investigated the influence of Factor V Leiden and prothrombin G20210A polymorphisms on thrombosis prevalence in lupus patients [7-12]. Additionally, some authors discuss the presence of recurrent miscarriages and fetal losses in SLE women with inherited thrombophilias [8,11], but no definitive conclusions occur. The present study aimed to investigate associations between the reproductive history of women with lupus and the common thrombophilic polymorphisms including Factor V Leiden (FVleiden), prothrombin G20210A (FII) and MTHFR C677T.



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