Migraineurs show a high prevalence of antiphospholipid antibodies

Abstract

Summary. Background: It has been observed that migraineurs show a higher risk of thrombosis and that the most frequent symptom reported by patients with antiphospholipid syndrome is headache, especially migraine. Objectives: The aim of our research was to evaluate the prevalence of antiphospholipid antibodies (aPL) in a random cohort of migraineurs. Patients/Methods: This analytic, comparative case study was performed to evaluate the prevalence of antiphospholipid antibodies by comparing a population of migraineurs with and without aura with sex-and age-matched controls. Both the diagnosis of migraine and the laboratory diagnosis of aPL positivity were made on the basis of the most recent international guidelines. Results: Between September 2008 and August 2009, we recruited 284 consecutive patients (225 women and 59 men, 203 without aura and 81 with aura) and 225 controls (174 women and 51 men). Positivity for at least one test for aPL (LAC, ACA IgG or antiß2GLP1 IgG) was detected and confirmed in 12% (n = 33) of patients and in 3% (n = 7) of controls (odds ratio, 4.08; confidence interval, 1.77-9:39; P = 0.0004). Two of the patients had triple positivity for aPL (LAC, ACA and antiß2GLP1) and one had double positivity (LAC and antiß2GLP1); none of the controls showed multiple positivity. Conclusions: Our data show that migraineurs have a significantly higher prevalence of antiphospholipid antibodies, and point towards the fact that the two conditions may be comorbid or even that migraine may be an early sign for identifying patients with aPL positivity.

Thrombophilic Disorders in Migraine

“…The diagnostic criteria accepted today are still those defined in the guidelines for the diagnosis of APS by Miyakis et al (23, 24). Beyond the risk of thrombosis, the link between aPL and migraine seems supported by the two studies, which have fulfilled these criteria (25, 26). These studies confirm that the prevalence of aPL positivity in migraineurs is higher than in controls, both in children than in adults.…”

Systemic lupus erythematosus: An update for ophthalmologists

“…While it is generally accepted that the management of primary anti-phospholipid syndrome and of anti-phospholipid syndrome in patients with SLE is no different, 35 . there are a number of controversial areas, including whether it is responsible for clinical manifestations that are not clearly a consequence of a defined thrombotic process, for example migraine or demyelination 18,56 . Similarly, there is controversy over management.…”

Thrombotic recurrences and bleeding events in APS vascular patients: A review from the literature and a comparison with the APS Piedmont Cohort

“…Unlike the Sapporo criteria, superficial thrombophlebitis and TIAs have been excluded, as having all nonobjectively or histologically documented events. Indeed, other clinical manifestations such as aPL positive thrombocytopenia, livedo reticularis and migraine, which are often associated to the syndrome [6] and [7], are actually considered non-criteria manifestations, and are followed separately. Laboratory diagnosis is now more standardized both for the LA test and for the cut-off values for aCL, and furthermore the antibeta2glycoprotein I assay has been added.…”