Antiphospholipid syndrome mimicking multiple sclerosis in two patients

Fernández–Fernández, Francisco José; Rivera-Gallego, Alberto; Fuente-Aguado, J. de la; Pérez‐Fernández, Silvia; Muñoz-Fernández, Delicias

doi:10.1016/j.ejim.2006.02.018

Cited by 15 publications

(7 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…MS-like syndrome, also called lupoid sclerosis, was described as a rare neurologic manifestation of primary APS. 75 Patients may present unbalance, visual or sensory complaints and other neurological deficits with relapsing-remitting course, similar to MS. 76 Furthermore, APS patients may present brain MRI with T2 hyperintense brain lesions, which may not be easily differentiated from MS. 77 In these particular cases, a careful interview may be helpful in distinguishing between MS and APS: the acute onset and resolution of symptoms, especially regarding visual symptoms (i.e. amaurosis fugax), presence of headache or epilepsy, prior history of thrombotic events and pregnancy morbidity strongly suggest APS rather than MS. 16 Several studies evaluated aPL in definite MS patients and in MS-like patients; however, their relevance are still unknown due high variability findings and methodological limitations.…”

Section: Ms-like Syndromementioning

confidence: 99%

Neurologic manifestations of antiphospholipid syndrome

Ricarte

Dutra

Abrantes

et al. 2018

Lupus

View full text Add to dashboard Cite

Neurological involvement in antiphospholipid antibody syndrome (APS) is common, and its occurrence increases morbidity and mortality. Patients may present variable neurological involvement, such as cerebrovascular disease, cognitive dysfunction, headache, seizures, movement disorders, multiple sclerosis-like syndrome, transverse myelitis and ocular symptoms. Most neurological manifestations are associated with thrombosis of the microcirculation or of large vessels; nonetheless, there is compelling evidence suggesting that, in some cases, symptoms are secondary to an immune-mediated pathogenesis, with direct binding of aPL on neurons and glia. Herein we describe clinical characteristics and management of neurological APS manifestations.

show abstract

Section: Ms-like Syndromementioning

confidence: 99%

Neurologic manifestations of antiphospholipid syndrome

Ricarte

Dutra

Abrantes

et al. 2018

Lupus

View full text Add to dashboard Cite

show abstract

“…However, both situations may be preceded by WM microstructural impairment, evidenced here by significantly lower anisotropy and higher diffusivity. In addition, as alterations in the WM of APS patients may mimic those caused by demyelinating disorders when imaged with traditional MR sequences [36,37], diffusion-based indices might facilitate discrimination of abnormalities caused by APS from those due to other disease states.…”

Section: Discussionmentioning

confidence: 99%

Diffusion tensor imaging in patients with obstetric antiphospholipid syndrome without neuropsychiatric symptoms

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Therefore, it seems probable that a small percentage of patients diagnosed with MS, do in fact have a primary neurological APS, a condition with an entirely different pharmacological treatment and that would condition prognosis too. APS misdiagnosis as MS makes a crucial point for the therapeutic approach, given the increased prothrombotic risk (Fernández-Fernández et al, 2006; Donnan and McDonald, 2009; Ahbeddou et al, 2012). Finally, the coexistence of both autoimmune diseases, like APS secondary to MS, could also be possible.…”

Section: Overlap Between Antiphospholipid Syndrome and Multiple Sclermentioning

confidence: 99%

Antiphospholipid Antibodies Overlapping in Isolated Neurological Syndrome and Multiple Sclerosis: Neurobiological Insights and Diagnostic Challenges

D’Angelo

Franch

Fernández-Paredes

et al. 2019

Front. Cell. Neurosci.

View full text Add to dashboard Cite

Antiphospholipid syndrome (APS) is characterized by arterial and venous thrombosis, pregnancy morbidity and fetal loss caused by pathogenic autoantibodies directed against phospholipids (PL) and PL-cofactors. Isolated neurological APS may represent a significant diagnostic challenge, as epidemiological, clinical and neuroimaging features may overlap with those of multiple sclerosis (MS). In an open view, MS could be considered as an organ-specific anti-lipid (phospholipid and glycosphingolipid associated proteins) disease, in which autoreactive B cells and CD8+ T cells play a dominant role in its pathophysiology. In MS, diverse autoantibodies against the lipid-protein cofactors of the myelin sheath have been described, whose pathophysiologic role has not been fully elucidated. We carried out a review to select clinical studies addressing the prevalence of antiphospholipid (aPL) autoantibodies in the so-called MS-like syndrome. The reported prevalence ranged between 2% and 88%, particularly aCL and aβ2GPI, with predominant IgM isotype and suggesting worse MS prognosis. Secondarily, an updated summary of current knowledge on the pathophysiological mechanisms and events responsible for these conditions is presented. We draw attention to the clinical relevance of diagnosing isolated neurological APS. Prompt and accurate diagnosis and antiaggregant and anticoagulant treatment of APS could be vital to prevent or at least reduce APS-related morbidity and mortality.

show abstract

Antiphospholipid syndrome mimicking multiple sclerosis in two patients

Cited by 15 publications

References 6 publications

Neurologic manifestations of antiphospholipid syndrome

Neurologic manifestations of antiphospholipid syndrome

Diffusion tensor imaging in patients with obstetric antiphospholipid syndrome without neuropsychiatric symptoms

Antiphospholipid Antibodies Overlapping in Isolated Neurological Syndrome and Multiple Sclerosis: Neurobiological Insights and Diagnostic Challenges

Contact Info

Product

Resources

About