To the Editor:
I read with great interest the article by Vlachoyiannopoulos, et al entitled “Upregulation of antiphospholipid antibodies following cyclophosphamide (CYC) therapy in patients with systemic lupus erythematosus”1. They report that CYC therapy may result in upregulation of antiphospholipid antibodies (aPL) as well as development of antiphospholipid syndrome (APS) in defiance of suppressed systemic lupus erythematosus (SLE) activity. A few points warrant further explanation by the authors.
While it has been reported that anticardiolipin antibody (aCL) IgG, aCL IgM, and lupus anticoagulant (LAC) may be observed fluctuating during the course of SLE, and LAC may be modified by the treatment with prednisolone2,3, Vlachoyiannopoulos, et al have neglected to call attention to this point in their article. Out, et al have reported that fluctuations in LAC and aCL IgM antibodies are not associated with disease activity, but that aCL IgG may be associated with disease activity2 …
Address reprint requests to Dr. C. Korkmaz, Osmangazi Üniversitesi, Tip Fakültesi, Ic Hastaliklari, Romatoloji Bölümü, 26480, Eskisehir, Türkiye. E-mail: ckorkmaz{at}ogu.edu.tr