Antiphospholipid antibody, head-shaking and ataxia: an evidence of non-vascular neurotoxicity and successful treatment by plasmapheresis.
Although antiphospholipid antibodies (APAbs) are considered to possess neurotoxic property, their relation with non-vascular neurological disorder is still disputed. This dilemma is mainly due to only a cross-sectional analysis or sporadic pictorial description in previous reports. In addition, treatment strategy is unknown in this situation. We encountered a patient who exhibited head-shaking and cerebellar ataxia had an increase of blood anti-beta2-glycoprotein I antibody and anticardiolipin antibody. Her neurological deficits did not respond to corticosteroid pulse therapy but rapidly subsided after plasmapheresis associated with a normalization of APAbs. Accordingly, a causal relation between APAbs and non-vascular neurological disorder is favored. The pathogenesis of APAb-related non-vascular neurotoxicity is warranted for further study to avoid premature conclusion. Plasmapheresis is recommended when movement disorder responds poorly to conventional treatment, especially when APAb is found.
Chen
Wei-Hsi
WH
Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, School of Medicine, Chang Gung University, 123 Tai Pei Road, Niao Sung Hsiang, Kaohsiung, Taiwan. brainhemostasis@yahoo.com
Chen
Chung-Jen
CJ
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000276:immunology* / Q000628:therapy; D001259:Ataxia / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D001323:Autoantibodies / Q000097:blood; D020274:Autoimmune Diseases of the Nervous System / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy; D002308:Cardiolipins / Q000276:immunology; D002490:Central Nervous System / Q000276:immunology / Q000503:physiopathology; D005260:Female; D019416:Head Movements / Q000502:physiology; D006801:Humans; D009069:Movement Disorders / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy; D009498:Neurotoxins / Q000276:immunology; D010956:Plasmapheresis; D016896:Treatment Outcome; D053482:beta 2-Glycoprotein I / Q000276:immunology
D000305:Adrenal Cortex Hormones; D001323:Autoantibodies; D002308:Cardiolipins; D009498:Neurotoxins; D053482:beta 2-Glycoprotein I