Chorea and high antiphospholipid antibodies: probable primary antiphospholipid syndrome

Area of Science:

• Neurology
• Rheumatology
• Immunology

Background:

• Antiphospholipid syndrome (APS) is an autoimmune disorder associated with an increased risk of thrombosis and pregnancy morbidity.
• Neurological manifestations of APS are diverse, with chorea being a rare but recognized symptom.

Purpose of the Study:

• To report a case of generalized chorea as the initial presentation of probable primary antiphospholipid syndrome.
• To highlight the importance of considering APS in the differential diagnosis of unexplained chorea.

Main Methods:

• Case report of a young male patient presenting with generalized chorea.
• Comprehensive laboratory investigations including coagulation studies, autoimmune markers, and serological tests.
• Brain magnetic resonance imaging (MRI) to evaluate for neurological abnormalities.

Main Results:

• The patient exhibited involuntary choreiform movements, mild thrombocytopenia, prolonged partial thromboplastin time (PTT), and positive antiphospholipid antibodies (aPL).
• Brain MRI revealed scattered white matter lesions.
• Treatment with aspirin and prednisone led to rapid symptomatic improvement.

Conclusions:

• Chorea can be the inaugural symptom of primary antiphospholipid syndrome.
• Screening for antiphospholipid antibodies should be considered in patients with unexplained chorea.