Neurol. praxi. 2009;10(1):54-57

Antiphospholipid syndrome, a syndrome which can mimic multiple sclerosis

MUDr. Petra Nytrová

Neurologická klinika 1. LF UK a VFN, Praha

Antiphospholipid syndrome (APS, also called as Hughes syndrome) is a relatively common autoimmune disorder characterized by recurrent

arterial or venous thromboses and/or pregnancy-related complications with a characteristic finding of antiphospholipid antibodies.

To diagnose APS, the following criteria must be met: one clinical criterion (i. e., the presence of thrombosis or repeated abortions or

preeclampsia) and one laboratory criterion, i. e., the demonstration of some of the antiphospholipid antibodies within a minimal time

interval of 12 weeks between individual laboratory tests. Antiphospholipid antibodies interfere with the homeostasis of blood coagulation

and cause hypercoagulation state by a variety of mechanisms. When APS occurs in patients with rheumatic disease, it is referred

to as secondary APS. The term „primary antiphospholipid syndrome“ (PAPS) is used when no other underlying disease is found. Within

APS, CNS can be involved as well. If this involement is characterized by recurrent arterial occlusions with attack–like course, it can mimic

for example multiple scelrosis (MS) and establishment of correct diagnosis can be difficult. The following case report of a woman, who

has been treated with MS for 10 years, is an evidence thereof. During severe brainstem attack, due to signs of multiorgan involvment

a systemic autoimmune disease was considered, with final conclusion of PAPS, which mimicked MS. The recognition of the correct diagnosis

is of major relevance to treatment planning and secondary prevention of further thrombotic complications.

Keywords: primary antiphospholipid syndrome, secondary antiphospholipid syndrome, Sneddon syndrome, multiple sclerosis

Published: March 1, 2009  Show citation