OBJETIVO: Traçar um perfil clínico e laboratorial da síndrome do antifosfolípide (SAF), comparando a primária (SAFP) com aquela secundária (SAFS) ao lúpus eritematoso sistêmico (LES). MÉTODOS: Avaliamos 27 pacientes com SAFP e 32 com SAFS ao LES, acompanhados no Ambulatório de Colagenoses do HC/FMRP/ USP, quanto à ocorrência de trombose arterial, venosa, perda gestacional, livedo reticular, fenômeno de Raynaud, anemia hemolítica auto-imune, plaquetopenia, linfopenia, anticorpos anticardiolipina, anticoagulante lúpico, antinucleares, anti-Sm e VDRL. Os anticorpos anticardiolipina e anti-Sm foram pesquisados por ELISA, os antinucleares por imunofluorescência indireta e o anticoagulante lúpico pelo tempo de protrombina diluída, tempo de coagulação do caulin ou tempo do veneno de víbora de Russell diluído. Para análise estatística utilizamos o teste exato de Fisher bicaudal. RESULTADOS: Observamos aumento da freqüência de trombose arterial na SAFP (59,3% vs 25,0%, p=0,009) e de trombose venosa na SAFS (53,1% vs 33,3%, p>0,05), enquanto não houve diferenças entre as freqüências de perda gestacional (50,0% vs 56,7%), fenômeno de Raynaud (18,5% vs 18,8%), livedo reticular (18,5% vs12,5%), anticoagulante lúpico (33,3% vs 37,5%) e anticardiolipina IgG (79,2% vs 72,4%) e IgM (58,4% vs 65,5%). Ademais, observamos aumento significante de linfopenia (71,2% vs 7,4%, p<0,0001), de anticorpos antinucleares (100% vs 7,4%, p<0,0001) e de VDRLpositivo (47,1% vs 5,0%, p=0,005) na SAFS ao LES quando comparada com a SAFP. CONCLUSÕES: As manifestações clínicas e laboratoriais são semelhantes na SAFP e na SAFS ao LES, sendo a trombose arterial mais comum na SAFP, enquanto a presença de linfopenia, anticorpos antinucleares e VDRL positivo está associada com a SAFS ao LES.

OBJECTIVE: To study clinical and laboratory features of primary antiphospholipid syndrome (PAPS) and that of secondary (SAPS) to systemic lupus erythematosus (SLE). METHODS: Twenty-seven PAPS and 32 SAPS patients were investigated in relation to the presence of arterial/venous thrombosis, fetal loss, reticular livedo, Raynaud phenomenon, autoimmune hemolytic anemia, thrombocytopenia, lymphopenia, anticardiolipin antibodies, lupus anticoagulant, antinuclear antibodies, anti-Sm and VDRL. Autoantibodies were investigated by ELISA (anticardiolipin and anti-Sm), indirect immunofluorescency (antinuclear antibodies) and by dilute prothrombin test, coagulation Kaolin test and dilute Russell viper venom test (lupus anticoagulant). RESULTS: Arterial thrombosis frequency was increased in PAPS (59.3% vs 25.0%, p=0.009) and venous thrombosis in SAPS (53.1% vs 33.3%; p>0.05), while there was no differences between frequencies of fetal loss (50.0% vs 56.7%), Raynaud phenomenon (18.5% vs 18.8%), reticular livedo (18.5% vs 12.5%), lupus anticoagulant (33.3% vs 37.5%), IgG anticardiolipin antibodies (79.2% vs 72,4%) and IgM anticardiolipin antibodies (58.4% vs 65.5%) in the two groups evaluated. Moreover, an increased frequency of lymphopenia (71.2% vs 7.4%; p<0.0001), antinuclear antibodies (100% vs 7.4%; p<0.0001) and positive VDRL (47.1% vs 5.0%, p=0.005) was observed in SAPS. CONCLUSIONS: Clinical and laboratory features were similar on PAPS and SAPS, although arterial thrombosis was associated to PAPS, and lymphopenia, antinuclear antibodies and VDRL were associated to SAPS.