Prevalence of antiphospholipid antibodies in patients with neurological symptoms

Neurological involvement is a common feature of the antiphospholipid syndrome (APS). A variety of thrombotic and non-thrombotic manifestations may accompany the presence of antiphospholipid antibodies (aPL).

We retrospectively reviewed the prevalence of aPL in a cohort of over 350 unselected patients from a neurological clinic and studied the neurological manifestations of APS.

We found that within this cohort the prevalence of aPL was about 15%. Most of the patients with aPL suffered from strokes and transient ischemic attacks (TIA). One patient died from spinal infarction. Non-thrombotic manifestations also occurred in 40% of these patients, such as multiple sclerosis, chorea, seizures or cerebral malignancies. No significant correlations of the titres or different types of aPL and the type of the neurological symptoms could be found. In comparison to age and sex matched patients of the cohort where the presence of aPL could be excluded, the occurrence of non-thrombotic manifestations was significantly more frequent and varied in the group of patients with aPL. The higher incidence of stroke in the non-APS group could be explained by the significantly higher presence of other laboratory risk factors, mainly hypercholesterinemia.

This investigation indicates that aPL may play an important role in the etiology of various neurological syndromes.