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Meta-Analysis
. 2021 Jan-Dec:27:10760296211002914.
doi: 10.1177/10760296211002914.

Antiphospholipid Antibodies in Sickle Cell Disease: A Systematic Review and Exploratory Meta-Analysis

Mira Merashli  1 , Alessia Arcaro  2 , Maria Graf  3 , Matilde Caruso  4 , Paul R J Ames  5   6 , Fabrizio Gentile  2
Affiliations
Meta-Analysis

Antiphospholipid Antibodies in Sickle Cell Disease: A Systematic Review and Exploratory Meta-Analysis

Mira Merashli et al. Clin Appl Thromb Hemost. 2021 Jan-Dec.

Abstract

The relationship between antiphospholipid antibodies (aPL) and sickle cell disease (SCD) has never been systematically addressed. Our aim was to evaluate potential links between SCD and aPL in all age groups. EMBASE/PubMed was screened from inception to May 2020 and Peto odds ratios for rare events were calculated. The pooled prevalence (PP) of IgG anticardiolipin antibodies (aCL) was higher in individuals with SCD than in controls (27.9% vs 8.7%, P < 0.0001), that of IgM aCL was similar in the two groups (2.9% vs 2.7%); only individuals with SCD were positive for lupus anticoagulant (LA) (7.7% vs 0%, P < 0.0001). The PP of leg ulcers was similar between aPL positive and negative individuals (44% vs 53%) and between patients in acute crisis and stable patients (5.6% vs 7.3%). Reporting of aPL as a binary outcome and not as a titer precluded further interpretation. The results indicate that a prospective case-control study with serial measurements of a panel of aPL in SCD patients might be warranted, in order to understand further the possible pathogenic role of aPL in SCD.

Keywords: anticardiolipin antibodies; antiphospholipid antibodies; leg ulcers; lupus anticoagulant; meta-analysis; sickle cell disease.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flow chart showing the study selection process.
Figure 2.
Figure 2.
Effect size of (A) IgG anticardiolipin antibodies (aCL), (B) IgM aCL and (C) lupus anticoagulant (LA) in participants with sickle cell disease (SCD) and controls (CTR). 95% CI: 95% confidence interval.
Figure 3.
Figure 3.
Relationship between antiphospholipid antibodies (aPL) and leg ulcers in individuals with sickle cell disease (SCD) and controls (CTR). 95% CI: 95% confidence interval.
See this image and copyright information in PMC

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