Title : A wide variety of neurologic manifestations in the antiphospholipid syndrome
Abstract:
Objectives: Aim of this study was to investigate association between neurological with manifestations and antiphospholipid antibodies type and level in APS patients.
Methods: Our prospective study comprises of 333 patients: 218 with primary and 115 with secondary APS. Antiphospholipid antibody (aPL) analysis included detection of aCL(IgG/IgM), ß2GPI(IgG/IgM) and LA and served to evaluate correlations with distinct neurological manifestations.
Results: Presence of aCL IgG was more common (p=0.001) in SAPS patients and LA in PAPS patients (p=0.002). According to gender, males more likely develop stoke (p=0.026) and multiinfarct dementia (p=0.004) in SAPS then females. High ß2GPI IgM levels (>100PLU/ml) were more common in epilepsy (p=0.00001) in PAPS, and in transient ischemic attack (p=0.029) in SAPS. High ß2GPI IgG levels (>100PLU/ml) were more common in stroke (p=0.036) and epilepsy (p=0.035) in SAPS. Almost significant was correlation between the presence of high and medium levels aCL IgM and migraine (p=0.053) in PAPS. Chorea, migraine and epilepsy occurred more often in SAPS and cerebral venous sinus thrombosis, cephalea and depression in PAPS. We revealed statistical significance considering the presence of aCL IgG and accute ischemic encephalopathy in SAPS, aCL IgM and epilepsy in SAPS, aCL IgM and migraine in PAPS, ß2GPI IgG and stroke and chorea in SAPS and ß2GPI IgM and TIA and epilepsy in PAPS. LA correlated with depression, transient global amnesia and migraine in PAPS.
Conclusion: Our study showed that certain aPL type and levels correlated with distinct neurological manifestation, suggesting their predictive role.