Neurological and Neuropsychiatric Manifestations of Antiphospholipid-Antibody Syndrome (APS)

Asif, Shaik Mohammed; Bali, Anoushka; Dang, Ashujot Kaur; Gonzalez, Daniel A; Kumar, Rajeswar

doi:10.7759/cureus.26022

Cited by 5 publications

(3 citation statements)

References 36 publications

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“…Además, los casos con LR y lesiones desmielinizantes presentaron un riesgo incrementado de éste. Del mismo modo, se demostró mayor frecuencia de deterioro cognitivo en aquellos pacientes con altos niveles de aFL comparado con los que presentaban niveles moderados (16) .…”

Section: Introductionunclassified

Manifestaciones clínicas “no criterio” del Síndrome Antifosfolipídico. Presentación de una cohorte nacional.

2023

Rev. urug. med. interna

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Clinical manifestations "not criteria" of Antiphospholipid Syndrome. Presentation of a national cohort.Manifestações clínicas "sem critério" da síndrome antifosfolipídica. Apresentação de uma coorte nacional. Resumen:Introducción: El síndrome antifosfolipídico (SAF) es una afección de origen autoinmune caracterizada por trombosis, pérdidas fetales recurrentes y anticuerpos antifosfolipídicos (aFL). Existen manifestaciones clínicas no contempladas en los criterios clasificatorios, que se denominan manifestaciones no criterio.Objetivo: Analizar las manifestaciones clínicas del SAF, enfatizando las manifestaciones no criterio y su relación con el perfil de autoanticuerpos en un hospital general de Montevideo, Uruguay.Métodos: Se realizó un estudio retrospectivo de las historias clínicas de pacientes con diagnóstico definitivo o sospecha de SAF en un servicio de medicina ambulatoria de enfermedades autoinmunes, en el Hospital Maciel, asistidos entre el 2010 y 2019.Resultados: Se incluyeron 78 pacientes, con edad media de 50,3 ± 14,5 años, 69 (88,5%) correspondió a sexo femenino. Cuarenta y seis (59,0%) pacientes presentaron SAF secundario, de los cuales 28 (35,9%) asociaron LES. La trombosis venosa de miembros inferiores fue la manifestación más frecuente (51,3%). Dieciocho (24,0%) pacientes presentaron trombosis arteriales en forma de accidente cerebrovascular.Cincuenta y nueve (75.6%) casos presentaron, además de las manifestaciones clasificatorias, alguna de las manifestaciones "no criterio" y éstas se manifestaron de forma aislada en 10 (12.8%) pacientes. Las manifestaciones no clasificatorias más frecuentes fueron artralgias, livedo reticularis, migraña y trombocitopenia. Se observó una asociación significativa entre la presencia de anti-β2GPI con manifestaciones cutáneas y de trombocitopenia con al menos una manifestación trombótica.Conclusiones: Las manifestaciones "no criterio" del SAF se presentaron en casi 3 de cada 4 casos, frecuencia similar a la observada en otras series. La presencia aislada de manifestaciones "no criterio" podrían hacer sospechar un SAF y en algunos casos, conducir a la solicitud de anticuerpos.

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Section: Introductionunclassified

Manifestaciones clínicas “no criterio” del Síndrome Antifosfolipídico. Presentación de una cohorte nacional.

2023

Rev. urug. med. interna

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“…Cognitive dysfunction is known to occur in autoimmune disorders [ 11 ]. Neurologic findings in APS are thought to occur in two phases [ 9 , 12 ]. In the first phase, aPL binds to endothelium in the brain, resulting in its dysfunction.…”

Section: Introductionmentioning

confidence: 99%

“…This dysfunction leads to microthrombosis as well as vessel inflammation and the release of neurotoxic cytokines. The second phase involves direct binding of aPL to neural cell surfaces, particularly neural cells with dopaminergic characteristics, leading to over-activation of N-methyl-D-aspartate (NMDA) glutamate receptors [ 9 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Antiphospholipid Syndrome Secondary to Lupus Anticoagulant: Case Report for Clinical Anticoagulation Determination

Lambroussis¹,

Foster²,

Sharma³

2022

Cureus

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Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by venous or arterial thrombosis and/or pregnancy morbidity in the presence of persistent laboratory evidence of antiphospholipid antibodies (APL). APS can occur as a primary condition but can also occur in the presence of systemic lupus erythematosus (SLE) or other systemic autoimmune diseases such as rheumatoid arthritis (RA) or Sjogren's Syndrome. Our case focuses on a 21-year-old female with a history of "going numb and having no ability to speak" with a total of approximately 20 such episodes, with no known triggers for these episodes. A hypercoagulable profile was performed and indicated an elevation in lupus anticoagulant (LA), which was also positive at repeat testing after 12 weeks, meeting the criteria for APS. Oral contraceptive pills (OCP) were stopped immediately, and she was started on daily aspirin. When hematology was consulted and evaluated, the patient reported a history of possible transient ischemic attacks (TIA); however, there was no history of deep vein thrombosis (DVT), pulmonary embolism (PE), or miscarriages. Recommendations from hematology were to continue the daily aspirin but did not recommend the addition of anticoagulation therapy. Additional recommendations included avoiding risk factors for thrombosis such as the use of birth control pills, smoking, and a sedentary lifestyle or obesity. Given the young age of our patient, as well as multiple TIA associated with APS secondary to LA, the patient was started on anticoagulation contrary to hematology's recommendations.

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Migraine in antiphospholipid syndrome and hereditary thrombophilia: pregnancy-related clinical and diagnostic features and therapeutic issues

Voskresenskaya,

Dashdamirova,

Khizroeva

et al. 2024

Akušerstvo, ginekologiâ i reprodukciâ

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Introduction. Migraine is one of the most common primary headaches and a risk factor for cardiovascular and cerebrovascular diseases. Antiphospholipid syndrome (APS) and hereditary thrombophilia (HT) causing pathological pregnancy are highly associated with migraine. Timely migraine recognition related to APS and HT facilitates earlier initiation of thrombophilia pathogenetic therapy and prevention of potential complications.Aim: to analyze the literature data on migraine clinical and diagnostic features in APS and HT as well as pregnancy-related therapeutic issues.Materials and Methods. A search for scientific literature was conducted in electronic databases including PubMed, Google Scholar, eLibrary from 2004 until May 2024. The search methodological basis included the presence of the following keywords and their combinations in Russian and English: "migraine", "antiphospholipid syndrome", "thrombophilia", "migraine and pregnancy", "migraine and thrombophilia", "migraine and cardiovascular diseases". As a result, a total of 184 publications were identified. Next, 62 articles were included in the review.Results. At the current stage, neurologists have no means to diagnose migraine in APS and HT based on headache-intrinsic characteristics. Pregnancy increases a risk of thrombotic complications. A migraine observed in patient's history should be crucial while assessing pregnancy-related obstetric risk. While diagnosing migraine, neurologists need to examine patient obstetric history. The data on most effective and safe therapy for pregnancy-related migraine attacks remain scarce.Conclusion. The frequent association between APS and HT with migraine, the lack of clear migraine clinical features in thrombophilia, patients’ reproductive age, and the high risk of thrombotic complications necessitate collaboration between neurologists and obstetricians-gynecologists for timely diagnostics and management of such patients. The impact of various types of antithrombotic therapy on migraine course requires further clarification. It is promising to conduct studies able to determine of whether migraine attack prevention can avoid adverse pregnancy outcomes in women with former migraine.

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Neurological and Neuropsychiatric Manifestations of Antiphospholipid-Antibody Syndrome (APS)

Cited by 5 publications

References 36 publications

Manifestaciones clínicas “no criterio” del Síndrome Antifosfolipídico. Presentación de una cohorte nacional.

Manifestaciones clínicas “no criterio” del Síndrome Antifosfolipídico. Presentación de una cohorte nacional.

Antiphospholipid Syndrome Secondary to Lupus Anticoagulant: Case Report for Clinical Anticoagulation Determination

Migraine in antiphospholipid syndrome and hereditary thrombophilia: pregnancy-related clinical and diagnostic features and therapeutic issues

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