[Myelopathy in patients with antiphospholipid antibodies: clinical features, pathogenesis, and review of literature].
We report 5 patients with anti-cardiolipin IgM-positive myelopathy. The lengths of spinal lesions were over two vertebral segments in 4 patients. Four cases showed subacute onset, and 2 out of these 4 cases had inflammatory changes in cerebrospinal fluid (CSF), and all of their symptoms improved. However, in one patient who showed an acute onset and normal findings of CSF, neurological symptoms did not improve. Three patients fulfilled the diagnostic criteria of primary antiphospholipid antibody syndrome. As for the pathophysiology of myelitis associated with antiphospholipid antibodies (aPL), it is suggested that vascular thrombosis affecting the blood cord barrier promotes an inflammatory changes. The heterogeneous CFS findings seem to reflect the difference in the intensity of inflammation. Both vascular thrombosis and inflammatory process should be considered as pathogenesis of these patients. Alone or combination therapy of steroids and anticoagulants might be effective in patients of myelopathy associated with APS.
Tsutsumi
Yukiko
Y
Department of Neurology, Neurological Institute, Tokyo Women's Medical University.
Mochizuki
Atsuko
A
Maruyama
Keiko
K
Uchiyama
Shinichiro
S
Iwata
Makoto
M
D000328:Adult; D000368:Aged; D017152:Antibodies, Antiphospholipid / Q000032:analysis*; D016736:Antiphospholipid Syndrome / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009187:Myelitis / Q000209:etiology* / Q000276:immunology*
D017152:Antibodies, Antiphospholipid; D007075:Immunoglobulin M