Acute optic neuropathy and transverse myelopathy in patients with                 antiphospholipid antibody syndrome: Favorable outcome after treatment with                 anticoagulants and glucocorticoids

Aziz, Auda; Conway, Mandi D.; Robertson, Hugh J.; Espinoza, Luis R.; Wilson, William S.

doi:10.1191/096120300680198944

Cited by 23 publications

(16 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although corticosteroids are not generally recommended in the treatment of APS, their use may be justified in patients with desperate situations, such as catastrophic APS with undefined therapeutic mechanism(s) (52,53). In the present study, DEX was shown to exhibit a dose-dependent inhibitory effect on both the basal and aCL-induced MCP-1 production (Fig.…”

Section: Discussionmentioning

confidence: 60%

Antiphospholipid Antibodies Induce Monocyte Chemoattractant Protein-1 in Endothelial Cells

Cho

Chen

et al. 2002

The Journal of Immunology

View full text Add to dashboard Cite

The presence of antiphospholipid Ab is associated with increased risk of thrombosis. The monocyte-endothelial cell interaction has been suggested to play a key role at the site of vascular injury during thrombosis. Therefore, we tested the effect of anticardiolipin Abs (aCL) on the production of monocyte chemoattractant protein-1 (MCP-1) in HUVEC. We found that monoclonal aCL as well as IgG fractions from patients with antiphospholipid syndrome (APS-IgG) could induce the production of MCP-1 in HUVEC. The ability of IgG aCL to induce MCP-1 production could be abrogated by preabsorption with cardiolipin liposomes. Simultaneous addition of either monoclonal aCL or APS-IgG with IL-1β resulted in synergistic increase in MCP-1 production, whereas the addition of control IgG lacking aCL activity did not alter IL-1β-induced levels of MCP-1. MCP-1 mRNA expression was also up-regulated when HUVEC were incubated with either APS-IgG or monoclonal aCL, and down-regulated by the treatment of dexamethasone. In addition, we found that serum levels of MCP-1 in 76 systemic lupus erythematosus patients correlated well with the titers of IgG aCL. Collectively, these results indicate that aCL could promote endothelial cell-monocyte cross-talk by enhancing the endothelial production of MCP-1, thereby shifting the hemostatic balance toward the prothrombotic state of APS.

show abstract

Section: Discussionmentioning

confidence: 60%

Antiphospholipid Antibodies Induce Monocyte Chemoattractant Protein-1 in Endothelial Cells

Cho

Chen

et al. 2002

The Journal of Immunology

View full text Add to dashboard Cite

show abstract

“…In addition, organic involvement in patients with antiphospholipid syndrome can appear on a spectrum from rapidly progressive to clinically silent and indolent. Furthermore, findings may either be isolated and limited to an end organ or widely disseminated and associated with systemic manifestations of antiphospholipid syndrome 14 …”

Section: Discussionmentioning

confidence: 99%

“…Of these medications, only warfarin has been shown to definitively be effective 11 . It is believed that glucocorticoid therapy, in addition to the anti‐inflammatory effects, may also protect neural tissues from ischemic injury, stabilize the vascular endothelium, and restore the blood‐brain barrier to normal 14 …”

Section: Discussionmentioning

confidence: 99%

“…Although it is difficult to justify committing this young, relatively healthy group of patients to a lifetime of anticoagulation when we have yet to confirm that the antibodies are mediating the disease, unfortunately, short of temporal bone biopsy to review the histopathology of the inner ear vessels, there is no test available to directly prove the diagnosis 14 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Antiphospholipid Inner Ear Syndrome

Mouadeb

Ruckenstein

2005

The Laryngoscope

View full text Add to dashboard Cite

These data support the hypothesis that antiphospholipid antibodies are involved in the pathogenesis of some forms of inner ear dysfunction, presumably by causing microthrombus formation in the labyrinthine vasculature. Basic science studies are required to better understand the mechanisms by which antiphospholipid antibodies mediate inner ear dysfunction. Clinical studies to evaluate the efficacy of anticoagulation in this group of patients are also required.

show abstract

“…Several patients have been observed who had recurrent episodes, with recurring hyperintensities and eventually cord atrophy [56]. Most patients responded to steroid pulse therapy with or without anticoagulation and some showed further response to cyclophosphamide [57]. Four of our patients have been treated with steroids in the acute phase and then by pulses of cyclophosphamide with continued improvement over 1 year.…”

Section: Myelopathymentioning

confidence: 83%