title: Hughes syndrome and multiple sclerosis.
abstract: Multiple sclerosis (MS) and antiphospholipid syndrome (APS) share common clinical, laboratory and radiological features. We reviewed all the English papers on MS and APS published in the literature from 1965 to 2014 using PubMed and Google Scholar. We found that APS can mimic antiphospholipid antibodies (aPL)-positive MS in many ways in its clinical presentation. Nevertheless, APS diagnosis, clinical manifestations and management differ from those of MS. aPL were found in MS patients with titers ranging from 2% to 88%. The distribution and volume of lesions on magnetic resonance imaging (MRI) may help to differentiate MS from primary APS. In addition, atypical MS presentation can guide physicians toward an alternative diagnosis, especially when features of thrombosis and/or history of connective tissue disease are present. In that case, an anticoagulation trial could be worthwhile.
authors.affiliation: Division of Rheumatology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon iuthman@aub.edu.lb.
authors.forename: I
authors.initials: I
authors.lastname: Uthman
authors.affiliation: Lebanese American University, Faculty of Medicine, Beirut, Lebanon.
authors.forename: M H A
authors.initials: MH
authors.lastname: Noureldine
authors.affiliation: Lebanese American University, Faculty of Medicine, Beirut, Lebanon.
authors.forename: A
authors.initials: A
authors.lastname: Berjawi
authors.affiliation: Lebanese American University, Faculty of Medicine, Beirut, Lebanon.
authors.forename: M
authors.initials: M
authors.lastname: Skaf
authors.affiliation: Lebanese American University, Faculty of Medicine, Beirut, Lebanon.
authors.forename: A A
authors.initials: AA
authors.lastname: Haydar
authors.affiliation: Rheumatology SpR, The Royal London Hospital, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Merashli
authors.affiliation: Graham Hughes Lupus Research Laboratory, The Rayne Institute, Lambeth Wing, St Thomas' Hospital, London, UK.
authors.forename: G R V
authors.initials: GR
authors.lastname: Hughes
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000276:immunology*; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000175:diagnosis* / Q000276:immunology / Q000503:physiopathology; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000276:immunology / Q000503:physiopathology; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology
chemical_list: D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants
keywords: Hughes syndrome; antiphospholipid antibodies (aPL); antiphospholipid syndrome (APS); multiple sclerosis (MS)