[Antibodies to phospholipids and ischemic disorders of cerebral circulation in young age]

Antibodies to phospholipids (APL) were studied in 97 patients which had ischemic stroke in young age (up to 46 years). These antibodies (Abs) were found in 25 patients (26%): Abs to cardiolipin--in 15 patients (60%), Abs to lupoid anticoagulant in 18 from 24 patients (75%), Abs to phosphatidylethanolamine--in 4 from 13 patients (31%). Disorders of cerebral circulation (DCC) usually began at the age of 14-45 years and were characterized by ischemic strokes and by transitory DCC. There was no correlation between the occlusion of extracranial arteries and their hemodynamic significant stenosis. There was occlusion of intracranial arteries in 7 from 12 patients (58%). Other risk factors of the stroke development were also found in 19 patients (76%) together with Abs to phopholipids. Other manifestations of antiphospholipid syndrome (APLS) were observed in 68% of the patients: miscarriage of pregnancy (63%), thrombosis of peripheric veins (16%), thrombocytopenia (32%), ischemic heart disease (28%). Comparison of APL+ and APL- patients revealed that transitory DCC, occlusion of intracranial arteries, intact extracranial arteries, widening or condensation of the cardial valves on echo-ECG, abortions, increase of ESR were significantly more frequently observed in the former group. For confirmation of APLS diagnosis it was necessary to study simultaneously Abs to cardiolipin and lupoid anticoagulant. Prophylaxis of repeated DCC in APLS included administration of both aspirin and anticoagulants of indirect action.