title: [Psychosis as debut of antiphospholipid syndrome].
abstract: BACKGROUND
  Antiphospholipid syndrome (APS) is an autoimmune disorder which causes an hypercoagulation state characterized by thrombotic events, repetitive miscarriages and the presence of antiphospholipid antibodies. APS may be an isolated disease (primary APS) or associated to systemic lupus erythematous or another autoimmune conditions (secondary APS). Neuropsychiatric manifestations accompanying APS include migraine, epilepsy, chorea, dementia or psychosis. Detailed descriptions of clinical cases are lacking, and correlations between clinical and analytical findings are far from being well known. We review literature concerning neuropsychiatric manifestations in general and psychosis in particular, in patients suffering from AFS.
  
  
  METHODS
  A 23 years-old female who presented a primary AFS with a clinical debut consisting of neuropsychiatric manifestations characterized by psychosis (with two delusion episodes) and abnormal movements such as choreiform and hemiballistic movements, initially understood as conversive symptoms.
  
  
  CONCLUSIONS
  We discuss the pathogenesis of the psychotic and motor manifestations. The etiology is nowadays not completely understood, but cerebral small vessel thrombosis might explain part of the manifestations. We also review the role of antipsychotic and antithrombotic medication for these patients. Currently, our patient remains asymptomatic without any antipsychotic agent, only being treated with antiagregant and antipalludic therapy.
authors.affiliation: Hospital Provincial de Conxo, Santiago de Compostela, Espana.
authors.forename: Lucía
authors.initials: L
authors.lastname: del Rio-Casanova
authors.forename: Eduardo
authors.initials: E
authors.lastname: Paz-Silva
authors.forename: Ignacio
authors.initials: I
authors.lastname: Requena-Caballero
authors.forename: Francisco
authors.initials: F
authors.lastname: Diaz-Llenderrozas
authors.forename: Jesús
authors.initials: J
authors.lastname: Gomez-Trigo Baldominos
authors.forename: Alberto
authors.initials: A
authors.lastname: de la Cruz-Davila
authors.forename: Mario
authors.initials: M
authors.lastname: Paramo-Fernandez
mesh_terms: D017153:Antibodies, Anticardiolipin / Q000097:blood*; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D001921:Brain / Q000473:pathology; D002819:Chorea / Q000209:etiology* / Q000503:physiopathology; D003291:Conversion Disorder / Q000175:diagnosis; D003693:Delirium / Q000209:etiology / Q000503:physiopathology; D003951:Diagnostic Errors; D020820:Dyskinesias / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006212:Hallucinations / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D020767:Intracranial Thrombosis / Q000209:etiology / Q000503:physiopathology; D016682:Lupus Coagulation Inhibitor / Q000097:blood*; D059906:Neuroimaging; D011618:Psychotic Disorders / Q000209:etiology* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D017153:Antibodies, Anticardiolipin; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D016682:Lupus Coagulation Inhibitor