State-of-the-Art-Review : The Leiden Mutation of Coagulation Factor V in Hungarian SLE Patients

Abstract

We studied the prevalence and the effect of coagu lation factor V Leiden mutation on the occurrence of throm botic episodes in 120 Hungarian patients having systemic lupus erythematosus (SLE) with or without antiphospholipid anti body. The frequency of the factor V Leiden mutation in Hungarian SLE patients was 13%, which is comparable with those found previously in a healthy Caucasian population. The incidence of venous thrombosis among factor V Leiden carriers has been found to be higher (odds ratio [OR] 1.7) than it is in patients without Leiden mutation (38% vs 29%). In addition, the fre quency of venous thrombosis in the heterozygous SLE patients (OR 8.4 [confidence interval (CI) 0.8-83.9] P=0.06) is depen dent on the coexistence of other risk factors, such as antiphos pholipid antibody. Moreover, among heterozygous factor V SLE patients, the Leiden mutation could explain the tendency to have significantly higher prevalence of fetal losses (OR 3.9 [CI 1.2-12.0] P = 0.02) and higher prevalence of cerebrovascu lar lesions, cardiac valvular abnormalities, and Raynaud's syn drome than that found in individuals without factor V Leiden mutation or those having antiphospholipid antibody. Systemic lupus erythematosus patients with combined de fects suffer more severely from thrombosis than those with a single risk factor do, suggesting that thrombophilia is a multi- factorial disorder in SLE, also. Although, the factor V Leiden mutation does not seem to be a significant risk factor for ve nous thrombosis in SLE, these data demonstrate that Leiden mutation can be regarded as an additive thrombogenic factor providing higher predisposition to several vasoocclusive disor ders in SLE.