title: Combination treatment of interferon β-1b and warfarin for a patient with Baló's concentric sclerosis and antiphospholipid syndrome.
abstract: BACKGROUND
  Baló's concentric sclerosis (BCS), a rare variant of multiple sclerosis (MS), as the initial presentation of antiphospholipid syndrome (APS) is unusual. The pathogenic role of antiphospholipid antibodies in the development of MS remains unknown. Anticoagulant therapy might be used in patients with MS and APS for prevention against the relapse of MS.
  
  
  METHODS
  We present a 27-year-old man diagnosed as BCS with APS. Initially, after corticosteroid therapy, he exhibited a complete recovery. During follow-up, his Baló-like lesion dissolved over time but transformed into other asymptomatic MS-like lesions. He also had persistently elevated anticardiolipin IgG levels. The patient was, therefore, on a combined therapy of interferon β-1b and an anticoagulant agent. No new brain lesions were found on 2 occasional head magnetic resonance imaging studies at 1 year follow-up.
  
  
  CONCLUSIONS
  To prevent further MS relapse and thrombotic complications of APS, a combined therapy of interferon β-1b and an anticoagulant agent can be an important strategy in treating patients with both BCS and APS.
authors.affiliation: Departments of *Neurology ‡Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei †Department of Neurology, Dalin Tzu-Chi General Hospital, Tzu Chi University, Hualien, Taiwan §School of Medicine & Health Sciences, University of Otago, Dunedin, New Zealand.
authors.forename: An-Chen
authors.initials: AC
authors.lastname: Tso
authors.forename: Wen-Long
authors.initials: WL
authors.lastname: Tsao
authors.forename: Cheng-Yu
authors.initials: CY
authors.lastname: Chen
authors.forename: Chwan-Fen
authors.initials: CF
authors.lastname: Yang
authors.forename: Giia-Sheun
authors.initials: GS
authors.lastname: Peng
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use*; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D001921:Brain / Q000473:pathology; D002549:Diffuse Cerebral Sclerosis of Schilder / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005018:Ethyl Chloride / Q000627:therapeutic use*; D006801:Humans; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male
chemical_list: D000276:Adjuvants, Immunologic; D000779:Anesthetics, Local; D000068576:Interferon beta-1b; D005018:Ethyl Chloride; D016899:Interferon-beta