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  Česky / Czech version Čes. a slov. Neurol. Neurochir., 64/97, 2001, No. 1, p. 31–35.
 
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
 


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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