Neurological Manifes-
tations in Patients with Antiphospholipid Antibodies
Szilasiová J. 1 , Klímová E. 1 , Szilasiová A. 2 , Čiderová A. 3 , Rosocha J. 4
1 Neurologická klinika, LF UPJŠ, Košice 2 II. interná klinika, LF UPJŠ, Košice 3 Klinická imunológia a alergológia, FNsP, Košice 4 Združená tkanivová banka, LF UPJŠ, Košice |
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Summary:
Background: Hypercoagulation states conditioned by the antiphospholipid syndrome (APS) may be the
cause of serious damage of the CNS. Objective: To assess the most frequent manifestations of CNS
damage in patients with anticardiolipin antibodies (aCLA). Patients and methods: In a retrospective
study of patients with positive aCLA hospitalized at the Neurological and Second Medical Clinic
between 1995 and 1999 the authors evaluated the extent of their neurological manifestations. For
assessment of aCLA they used the sandwich method of enzyme immunoanalysis (ELISA) in Cebecauer’s
modification. Results: aCLA positivity in suspected thromboembolic disease was found in 76 patients
(21.1%). Neurological manifestations were recorded in 11 patients (14.5%). The mean age of the patients
was 48.2 ± 10.5 years. Positivity of aCLA isotypes IgG and IgM was recorded in four patients, seven
patients had only the IgG isotype. All sub-classes of aCLA (IgG, IgM, IgA) were found in one female
patient. Thrombocytopenia was confirmed in ten patients (values below 150x10 9 /l). The following
neurological manifestations were recorded in patients: cerebrovascular attack type TIA (1x), thrombo-
sis of the cerebral sinuses (1x), monocular visual disorder caused by thrombosis of the central retinal
vein (1x), syndrome of benign intracranial hypertension (1x), cerebral infarction in 8 patients, incl. six
with infarction in the carotid circulation and two in the vertebrobasilar circulation. Relapses of
cerebral infarction occurred in five patients. Conclusion: Manifestations of ischaemia of the CNS, in
particular in younger patients who suffer at the same time from thrombocytopenia, should be an
indication for examination of aCLA antibodies as their permanent presence increases the risk of further
thromboembolic attacks.
Key words:
antiphospholipid syndrome, anticardiolipin antibodies, thrombosis, cerebrovascular at-
tacks
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