Title:Prevalence of Anti-nuclear and Anti-phospholipid Antibodies in an Egyptian
Cohort with Schizophrenia: A Case-control Study
Volume: 18
Issue: 3
Author(s): Basma M. Medhat*, Mohammed H. Abu-Zaid, Dalia Dorgham, Nehal El-Ghobashy, Angie Y. Afifi, Shirin El-Makawi, Doaa R. Ayoub, Ola O. Khalaf, Reham Amer, Dina M.T. Koptan and Lobna A. Maged
Affiliation:
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Kasr Alainy, Cairo, Egypt
Keywords:
Anti-nuclear antibodies, anti-phospholipid antibodies, anti-phospholipid syndrome, neuropsychiatric, psychosis, schizophrenia, systemic lupus erythematosus.
Abstract:
Background: Psychiatric disorders, including schizophrenia, could herald other manifestation(
s) of systemic lupus erythematosus (SLE) potentially hindering timely and optimal management.
Moreover, schizophrenia is among the described ‘extra-criteria’ manifestations of anti-phospholipid
syndrome (APS). Hence, screening schizophrenia patients for SLE and APS may pose diagnostic
and therapeutic implications.
Objectives: Examine schizophrenia patients with no overt connective tissue disease(s) manifestation(
s) for clinical and/or serologic evidence of SLE and/or APS.
Methods: The study included 92 schizophrenia patients (61 (66.3%) males) and 100 age- and gender-
matched healthy controls. Both groups were tested for anti-nuclear antibodies (ANAs), antidouble
stranded deoxyribonucleic acid (anti-dsDNA) antibodies, complement 3 (C3) and C4, and
criteria anti-phospholipid antibodies (aPL) (anticardiolipin Immunoglobulin (Ig) G and IgM, antibeta-
2-glycoprotein I IgG and IgM, and lupus anticoagulant (LAC)).
Results: The patients’ mean age and disease duration were 28.8 ± 8.1 and 5.7 ± 2.2 years, respectively.
The prevalence of ANA positivity, height of titre, and pattern was comparable between patients
and controls (p = 0.9, p = 0.8 and p = 0.1, respectively). Anti-dsDNA antibodies and hypocomplementemia
were absent in both groups. A significantly higher frequency of positive LAC
was observed among patients compared with controls (7.6% vs. 1%, p = 0.02), whereas other aPL
were comparable between both groups. None of the patients or controls demonstrated clinically
meaningful (medium or high) aPL titres.
Conclusion: In our study, schizophrenia was solely associated with LAC. Thus, in the absence of
findings suggestive of SLE or APS, routine screening for both diseases is questionable.
