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The frequency and significance of anticardiolipin antibodies in scleroderma.

OBJECTIVE
To determine the frequency and significance of anticardiolipin antibodies (aCL) in scleroderma.


METHODS
We serially tested for aCL in a standardized fashion in patients with scleroderma who were outpatients and gave consent to enter this study.


RESULTS
Sixty-three patients participated in this study. Thirty-six had diffuse scleroderma and 27 had limited scleroderma. Three (4.8%) were positive for aCL, of whom 2 had limited scleroderma. In only one patient aCL may have been clinically significant. This woman had limited scleroderma for years and had medium vessel occlusive disease with gangrene eventually requiring midfoot amputations and chronic warfarin treatment. She did not have features of systemic lupus erythematosus or other overlap conditions. The other 2 patients had no manifestations of the antiphospholipid antibody syndrome.


CONCLUSION
aCL in scleroderma rarely manifest clinically. The range of frequency of positive aCL in the literature is from 0 to 63%. From our study and the literature, we cannot ascertain if the prevalence is different in limited and diffuse scleroderma.